Analysis of risk factors for perioperative complications in spine surgery

Abstract

Complications in spine surgery can arise in the intraoperative or the immediate postoperative period or in a delayed manner. These complications may lead to severe or even permanent morbidity if left undiagnosed and untreated. We prospectively interviewed 526 patients out of 1140 patients who consecutively underwent spinal surgery in our department between November 2017 and November 2018 and analysed the outcome and complication rates. A 12 months follow-up period was also adopted. We analysed the patients’ clinical characteristics, comorbidities, surgical management, survival rates, and outcomes. Risk factor analyses for the development of complications were also performed. Patients’ median age was 67 years (range: 13–96). The main diagnoses were as follows: degenerative in 50%, tumour in 22%, traumatic fractures in 13%, infections in 10%, reoperations in 3%, and others in 2%. Surgeries were emergency procedures (within 24 h) in 12%. Furthermore, 59% required instrumentation. The overall postoperative complication rate was 26%. Revision surgery was required in 12% of cases within 30 postoperative days (median time to revision 11 days [IQR 5–15 days]). The most frequent complications included wound healing disorders, re-bleeding, and CSF leakage. Thereby, the risk factor analysis revealed age-adjusted CCI (p = 0.01), metastatic tumour (p = 0.01), and atrial fibrillation (p = 0.02) as significant risk factors for postoperative complications. Additionally, postoperative KPS (p = 0.004), postoperative anaemia (p = 0.001), the length of hospital stay (p = 0.02), and duration of surgery (p = 00.002) were also identified as associated factors. Complication rates after spinal surgeries are still high, especially in patients with metastatic tumour disease and poor clinical status (KPS), requiring revision surgeries in several cases. Therefore, specific risk factors should be determined to carefully select surgery groups.

Influence of Dental Status on Postoperative Complications in Major Visceral Surgical and Organ Transplantation Procedures - the BellyDent retrospective observational Study

“…Patients wearing complete or partial dentures were classi ed as having poor dental status. This classi cation is based on several studies that followed the same approach [28, 30,36,37]. This is grounded on the assumption that an oral disease, such as caries or periodontitis, leads to tooth loss and thus indicates an existing poor dental status.…”

Evaluating Risk Factors and Complications in Mandibular Ramus Block Grafting: A Retrospective Cohort Study

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Hidden Blood Loss and Its Possible Risk Factors in Full Endoscopic Lumbar Interbody Fusion

“…The interlaminar approach was applied at L5/S1 or when dorsal decompression of the spinal canal was required. Trans-Kambin approach: intervertebral space of surgical segments was located by fluoros [12] copy, a line 5-10 • to the horizontal of the disc along the upper inner edge of the inferior pedicle was drawn. About 8-10 cm from the spinous process, a puncture to the foramen area was performed under the guidance of fluoroscopy.…”

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