<p>Perioperative Complications And Risk Factors In Degenerative Lumbar Scoliosis Surgery For Patients Older Than 70 Years Of Age</p>

Abstract

Study design: Multivariate analysis of retrospective registry data. Objective: To report the perioperative complication in a large cohort of surgery for elderly degenerative lumbar scoliosis (DLS) patients and to analyze the risk factors. Summary of background data: The perioperative complication rate and risk factors for patients with DLS remain unclear, especially in elderly population. Methods: Between November 2015 and June 2018, 98 patients aged 70 or older with DLS received decompression and intervertebral fusion by one spine surgeon at Beijing Xuanwu Hospital. The medical history and comorbidities of all patients were recorded. Results: The perioperative complication rate was 34.7% in all patients, 11.2% of all patients had major complications, and 31.6% had minor complications. The major complication most commonly seen was wound infection, and the most common minor complication was hypoproteinemia. Elderly patients (>75) had longer hospital stays (17.5 ± 7.9) when compared to younger patients. Two risk factors of perioperative complications were chosen after binary logistic regression analysis: lower BMI and longer instrumented segments. The only risk factor for major complications was longer instrumented level (≥3), and the only risk factor for minor complications was lower BMI. Conclusion: Our findings indicate that in elderly patients with DLS, lower BMI is a risk factor for minor perioperative complication. Obesity is not a major problem in this population, on the contrary, BMI is a protective factor for perioperative complications. The risk factors for major perioperative complications in elderly patients with DLS are longer instrumented segments but not related to the number of decompression and intervertebral fusion levels. Preoperative comorbidities and advanced age were not associated to a higher perioperative complication rate in elderly patients. The perioperative complication rate in patients with DLS over 70 years of age is found to be acceptable with appropriate perioperative management.

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

“…The grade of lumbar spinal stenosis was based on the morphology of the dural sac on MRI, according to the criteria of Schizas et al [ 20 ]. Degenerative lumbar scoliosis is a three-dimensional spinal deformity with a Cobb angle greater than 10 degrees [ 21 , 22 ]. Lumbar lordosis was defined as the angle between the superior endplates of L1 and S1 [ 23 ].…”

Obesity and Spine Surgery: A Qualitative Review About Outcomes and Complications. Is It Time for New Perspectives on Future Researches?

“…Therefore, patients with high BMI should be advised concerning the risk of postoperative complications related to cervical spine surgery and, besides, whereby allowed by neurological impairment, a weight loss program with the aim to reduce the pre-operative BMI could be considered. 68 Retrospective cohort study 15 Qi M et al, 2020 69 Retrospective study 20 Basques et al, 2019 74 Retrospective cohort study 26 Kashkoush A et al, 2019 79 Retrospective study 29 Malik AT et al, 2019 81 Retrospective study 33 Zhang G.A. et al, 2019 18 Meta-analysis 44…”

“…Type of study 13 Malik AT et al, 2020 68 Retrospective cohort study 15 Qi M et al, 2020 69 Retrospective study 20 Basques et al, 2019 74 Retrospective cohort study 26 Kashkoush A et al, 2019 79 Retrospective study 29 Malik AT et al, 2019 81 Retrospective study 33 Zhang G.A. et al, 2019 18 Meta-analysis 44…”

“…Additionally, although several studies now revealed a higher complication rate, inferior clinical outcomes among obese population have not been consistently demonstrated being the topic still controversial. 29 - 40 Puvanesarajah et al investigated the role of obesity on 90-day complication rates and 30-day readmission rates following 1- to 2-level, primary, lumbar spinal fusion surgery for degenerative pathology in an elderly population. Obese patients resulted to have significantly higher odds of suffering from any 1 major medical complication (odds ratio [OR] 1.79).…”

Clinical Outcome-Supported Advance of Cement Lumber Interbody Fusion for Degenerative Lumbar Scoliosis

“…However, posterior instrumentation with bone graft for the treatment of DLS is not only time consuming but with high risk of complications [3][4][5]. Complex spinal fusions for the elder with fragile comorbidities may increase risk to face major complications [6]. Even with modern technology of Minimally Invasive Surgeries (MIS), the intraoperative and post-operative complications were 2.5 and 10.2% respectively for Transforaminal Lumbar Interbody Fusion (TLIF), and 2.2 and 7.8% respectively for percutaneous endoscopic TLIF [7].…”