Yasuaki Imajo1, Toshihiko Taguchi2, Masashi Neo3, Koji Otani4, Tadanori Ogata5, Hiroshi Ozawa6, Naohisa Miyakoshi7, Hideki Murakami8, Tetsuhiro Iguchi9. 1. Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan. Electronic address: i-yasuak@yamaguchi-u.ac.jp. 2. Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan. 3. Department of Orthopedic Surgery, Osaka Medical College, Japan. 4. Department of Orthopaedic Surgery, Faculty of Medicine, Fukushima Medical University, School of Medicine, Japan. 5. Spine Center, Ehime University Hospital, Japan. 6. Department of Orthopaedic Surgery, Tohoku University School of Medicine, Japan. 7. Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan. 8. Department of Orthopaedic Surgery, Graduate School of Medical Science Kanazawa University, Japan. 9. Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Japan.
Abstract
BACKGROUND: The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years. METHODS: A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data. Data were returned by the end of May 2012. RESULTS: Data were accumulated for 8033 patients aged 65 years. The incidence of surgical complications was 10.8%, and did not differ significantly between age groups. The incidence of general complications was 2.7%, and differed significantly between age groups (p < 0.005). The highest incidence of surgical complications was for dural tear (DT) (3.6%), followed by deep wound infection (DWI) (1.4%), neurological complications (1.3%), and epidural hematoma (1.3%). Spinal instrumentation was applied in 30.3%. Incidences of surgical complications in instrumented and noninstrumented surgery were 17.3% and 8.8%. In instrumented surgery, incidences of surgical and general complications were higher in the ≥80 year age group than in the 65-79 year age group. Logistic regression analyses showed patients with microendoscopic surgery at increased risk of DT. Patients with diabetes mellitus and instrumented surgery showed increased risks of DWI. CONCLUSIONS: Incidences of surgical complications did not differ significantly between age groups. Attention should be paid to both surgical and general complications, particularly for postoperative mental disease in instrumented surgery for patients≥80 years old.
BACKGROUND: The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years. METHODS: A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data. Data were returned by the end of May 2012. RESULTS: Data were accumulated for 8033 patients aged 65 years. The incidence of surgical complications was 10.8%, and did not differ significantly between age groups. The incidence of general complications was 2.7%, and differed significantly between age groups (p < 0.005). The highest incidence of surgical complications was for dural tear (DT) (3.6%), followed by deep wound infection (DWI) (1.4%), neurological complications (1.3%), and epidural hematoma (1.3%). Spinal instrumentation was applied in 30.3%. Incidences of surgical complications in instrumented and noninstrumented surgery were 17.3% and 8.8%. In instrumented surgery, incidences of surgical and general complications were higher in the ≥80 year age group than in the 65-79 year age group. Logistic regression analyses showed patients with microendoscopic surgery at increased risk of DT. Patients with diabetes mellitus and instrumented surgery showed increased risks of DWI. CONCLUSIONS: Incidences of surgical complications did not differ significantly between age groups. Attention should be paid to both surgical and general complications, particularly for postoperative mental disease in instrumented surgery for patients≥80 years old.