Fracture fixation in patients with osteopetrosis requires strategies to overcome the technical difficulties found during the procedure. Preoperative planning must include the availability of multiple metal drill bits, electric drills, and bone substitutes, having in mind drilling techniques, drilling speed, and temperature control. Patients should be closely followed to evidence any complications such as infections and malunions.
Introduction
Degenerative lumbar spinal stenosis is present in patients around 50 to 60 years old. It is the most common spinal surgical indication in patients over 65 years old. The aim of this study was to determine the risk factors associated with adverse events and reintervention after surgery for degenerative lumbar spinal stenosis, based on a 10-year retrospective analysis of clinical records in a third level hospital in Bogotá, Colombia.
Material and Methods
An analytical prevalence study was developed through 429 clinical records of patients who underwent surgery for degenerative lumbar spinal stenosis.
Results
429 clinical records were reviewed. 55% were female; the mean age was 55 years +/−16,5. The average follow up was 33,8 months. Adverse events were present in 17,2% of patients. Dural lesion was the most frequent complication (9.8%). Multivariate analysis showed a relation between complications and BMI (OR 1,8; p = 0,029), duration of symptoms (OR 1,08; p = 0,047), length of stay (OR 1,67; p = 0,023) and multi level surgery (OR: 2.99; p = 0,015). 4.7% of patients required early reintervention after surgery and 16,1% required it during follow-up. The most common late reintervention cause was re-stenosis of the same segment (7%). Adjacent segment disease was present in 6,1% of patients.
Conclusion
BMI, duration of symptoms, length of stay and multi level surgery were identified as risk factors for adverse events and reintervention after surgery for degenerative lumbar spinal stenosis. Mitigation of these risk factors before surgery for degenerative lumbar spinal stenosis, may decrease the proportion of complications and reinterventions in our institutions.
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