Kevin Phan1, Vignesh Ramachandran2, Tommy Tran2, Steven Phan1, Prashanth J Rao3, Ralph J Mobbs4. 1. NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia. 2. Baylor College of Medicine, Houston, Texas, USA. 3. NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Randwick, Sydney, Australia. 4. NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Randwick, Sydney, Australia. Electronic address: ralphmobbs@hotmail.com.
Abstract
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon. Patients were separated into age-based cohorts (≤49, 50-63, and ≥64 years of age). Chi-squared, Fisher exact test, and multivariate logistic regression models were used to identify independent risk factors. RESULTS: A total of 137 patients met the inclusion criteria. Patients were divided into age-based tertiles as follows: Group 1 (<49 years old, n = 45, 32.8%), Group 2 (50-63 years old, n = 46, 33.6%), and Group 3 (64 years old, n = 46, 33.6%). Univariate analysis revealed increasing age (relative to Group 1) to be an independent risk factor for postoperative hematoma and delayed subsidence at 6 weeks and 12 weeks postoperatively compared with immediately post operation (all P < 0.05). No significant differences were found among the groups in terms of clinical outcome. Multivariate analysis also demonstrated increased age to be independently associated with greater prevalence of delayed subsidence (odds ratio 9.174, P = 0.029). CONCLUSIONS: Increased age was not associated with adverse perioperative outcomes and complications of ALIF. However, there was an increased incidence of delayed subsidence in patients ≥64 years old.
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon. Patients were separated into age-based cohorts (≤49, 50-63, and ≥64 years of age). Chi-squared, Fisher exact test, and multivariate logistic regression models were used to identify independent risk factors. RESULTS: A total of 137 patients met the inclusion criteria. Patients were divided into age-based tertiles as follows: Group 1 (<49 years old, n = 45, 32.8%), Group 2 (50-63 years old, n = 46, 33.6%), and Group 3 (64 years old, n = 46, 33.6%). Univariate analysis revealed increasing age (relative to Group 1) to be an independent risk factor for postoperative hematoma and delayed subsidence at 6 weeks and 12 weeks postoperatively compared with immediately post operation (all P < 0.05). No significant differences were found among the groups in terms of clinical outcome. Multivariate analysis also demonstrated increased age to be independently associated with greater prevalence of delayed subsidence (odds ratio 9.174, P = 0.029). CONCLUSIONS: Increased age was not associated with adverse perioperative outcomes and complications of ALIF. However, there was an increased incidence of delayed subsidence in patients ≥64 years old.
Authors: Seth Ahlquist; Rachel Thommen; Howard Y Park; William Sheppard; Kevin James; Elizabeth Lord; Arya N Shamie; Don Y Park Journal: J Spine Surg Date: 2020-12
Authors: Graham Seow-Hng Goh; You Wei Adriel Tay; Ming Han Lincoln Liow; Cheryl Gatot; Zhixing Marcus Ling; Poh Ling Fong; Reuben Chee Cheong Soh; Chang Ming Guo; Wai-Mun Yue; Seang-Beng Tan; John Li-Tat Chen Journal: Clin Orthop Relat Res Date: 2020-04 Impact factor: 4.755