Perioperative Complications of Posterior Lumbar Decompression and Arthrodesis in Older Adults

• Published in: Journal of bone and joint surgery. American volume 2003-11, Vol.85 (11), p.2089-2092
• Main Authors: Carreon, Leah Y, Puno, Rolando M, Dimar, John R, Glassman, Steven D, Johnson, John R
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Bone Transplantation - adverse effects; Decompression, Surgical - adverse effects; Diseases of the osteoarticular system; Diseases of the spine; Female; Humans; Lumbar Vertebrae; Male; Medical sciences; Orthopedic Procedures - adverse effects; Orthopedic surgery; Postoperative Complications - etiology; Retrospective Studies; Spinal Diseases - surgery; Spinal Fusion - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-200311000-00004

BackgroundLumbar arthrodesis is commonly done in elderly patients to treat degenerative spine problems. These patients may be at increased risk for complications because of their age and associated medical conditions. In this study, we examined the rates of perioperative complications associated with posterior lumbar decompression and arthrodesis in patients sixty-five years of age or older.MethodsWe reviewed the hospital records of ninety-eight patients who were sixty-five years of age or older when they had a posterior decompression and lumbar arthrodesis with instrumentation, between 1993 and 1995, to treat degenerative disease of the spine. The average age was seventy-two years (range, sixty-five to eighty-four years).ResultsPerioperative complications occurred in seventy-eight patients. Twenty-one patients had at least one major complication, and sixty-nine had at least one minor complication. Forty-nine patients had more than one complication. The most common major complication was wound infection (prevalence, 10%), and the most common minor complication was urinary tract infection (prevalence, 34%). The complication rate increased with older age, increased blood loss, longer operative time, and the number of levels of the arthrodesis.ConclusionsSurgeons should be vigilant about perioperative complications in elderly patients treated with multi-level lumbar decompression and arthrodesis with instrumentation. Elderly patients should be made aware that they are at increased risk for surgical complications because of their age. Attention should be paid to controlling blood loss and limiting operative time.Level of EvidencePrognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.