Surgical Results and Complications in Elderly Patients with Benign Lesions of the Spinal Canal

Smith, Edward B.; Hanigan, William C.

doi:10.1111/j.1532-5415.1992.tb01981.x

Cited by 40 publications

(19 citation statements)

References 19 publications

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“…This is somewhat different from the results of Carreon et al 4) . While some have found the presence or number of comorbidities to increase the complication rate 6,9,18) , others have not found this to be the case 2,4,17) . Chronic disease has been shown to impact mortality dramatically.…”

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confidence: 99%

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

Jun

Kim

et al. 2010

J Korean Neurosurg Soc

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Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (36.1%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A, perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

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confidence: 99%

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

Jun

Kim

et al. 2010

J Korean Neurosurg Soc

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“…In the single-level group, the preoperative JOA scores averaged 13.3 points (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] There were also no major complications in this group. However, one patient had a postoperative recurrence of the symptoms within 5 months and required additional posterior decompression at the same spinal level.…”

Section: Resultsmentioning

confidence: 99%

“…There may be considerable complications even in decompression surgery, especially in elderly or multiply operated patients [21,22]. Minimally invasive surgery should be attempted to reduce operative complications.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis with multiple-level involvement

Tanaka

Nakanishi

Kamei

et al. 2014

Eur J Orthop Surg Traumatol

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“…5,9,10,16,18 Even with the fact that elderly patients frequently have considerable postoperative complications, 14 surgery for cervical myelopathy is beneficial if the operation is appropriately planned. Furthermore, patients older than 80 years of age frequently have accompanying age-related degeneration of the central and/or peripheral nervous systems, disabilities of motor functions, and other general complications.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of cervical myelopathy in patients older than 80 years of age: evaluation of spinal function with motor evoked potentials

Tanaka

Nakanishi

Fujimoto

et al. 2009

SPI

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Object In this prospective analysis the authors describe the clinical results of surgical treatment in patients > 80 years of age in whom spinal function was evaluated with motor evoked potential (MEPs) monitoring. Methods The authors included 57 patients > 80 years of age who were suspected of having cervical myelopathy. The mean age of the patients was 83.0 years (range 80–90 years). The central motor conduction time (CMCT) was calculated from the latencies of the MEPs following transcranial magnetic stimulation and from M and F waves following peripheral nerve stimulation. Results Preoperative electrophysiological evaluation demonstrated significant elongation of CMCT or abnormalities in MEP waveforms in 37 patients (65%), and 35 patients of these underwent laminoplasty. In 30 patients cervical spondylotic myelopathy was diagnosed and 5 patients ossification of the posterior longitudinal ligament was diagnosed. The preoperative mean Japanese Orthopaedic Association Scale score was 8.6 (range 3–12.5) and the mean postoperative score was 12.6 (range 6–14.5) with an average recovery rate of 45% (range −21 to 100%). There were no major complications in any of the patients during the operative period and there were no cases of death resulting from operative intervention. Conclusions Sufficient clinical results are expected even in patients with myelopathy who are older than 80 years of age, provided the patients are correctly selected by electrophysiological evaluation with MEPs and CMCT.

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Surgical Results and Complications in Elderly Patients with Benign Lesions of the Spinal Canal

Cited by 40 publications

References 19 publications

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

Clinical results of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis with multiple-level involvement

Clinical results of cervical myelopathy in patients older than 80 years of age: evaluation of spinal function with motor evoked potentials

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