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Journal List > J Korean Soc Spine Surg > v.13(2) > 1035704

Park, Lee, Lee, and Park: Postoperative Complications in Patients over 65 years of Age with Lumbar Spinal Stenosis and its Influencing Factors

Abstract

Study design

This is a retrospective study.

Objectives

The purpose of this study is to decrease the frequency of the postoperative complications and to improve the postoperative clinical outcomes for the elderly patients with lumbar spinal stenosis. Summery of Literature Review: Many controversies exist about postoperative complication and its influencing factors in the elderly patients suffering with lumbar spinal stenosis.

Materials and Methods

We reviewed the hospital records of 213 patients who underwent decompression and posterolateral fusion between February 1, 1998 and December 31, 2003 to treat their degenerative lumbar spinal stenosis. This study was per-formed, to assess and compare the postoperative complications and clinical outcomes of surgical management for the patients over 65 years (Group A) and the patients between 50-64 years (Group B). All the patients had at least a 1-year follow-up evaluation. The factors that could have influenced the complications that resulted within 12 weeks after the operation were evaluated and statistically analyzed.

Results

Postoperative complications occurred in 62 patients of Group A and in 40 patients of Group B, of which the major complications occurred in 10 patients of Group A and in 1 patient of Group B and minor complications occurred in 52 patients of Group A and in 39 patients of Group B. A statistical relationship between diabetes and major complications was observed in Group A (p=0.005). While any relationship between age and the frequency of complication in each group was not found, Group A had a higher frequency of major complication than did Group B (p=0.004).

Conclusions

Surgeon should be vigilant about postoperative complications in elderly patients suffering with diabetic mellitus. Elderly patients with diabetic mellitus should be made aware that they are at an increased risk for postoperative complications because of their fragility.

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Table 1.
Clinical Outcome Measurement
Group Back Pain Leg Pain Activity Medication
Excellent Occasional None Normal None
Good Mild Mild Normal NSAIDs
Fair Moderate Moderate Restricted NSAIDs
Poor Severe Severe Restricted Narcotics
Table 2.
Complications
Comorbidity Group A (%) Group B (%)
Hypertension 45 (40.9%) 35 (33.9%)
Diabetes mellitus 31 (28.2%) 19 (18.4%)
Coronary artery disease 12 (10.9%) 02 (01.9%)
Previous cardiac infarction - -
Congestive heart failure 01 (00.9%) -
Arrythmia 01 (00.9%) 01 (00.9%)
Chronic obstructive pulmonary disease 02 (01.8%) 02 (01.9%)
Rheumatoid arthritis - -
Osteoarthritis 01 (00.9%) 03 (02.9%)
etc 07 (06.4%) 08 (07.8%)
Table 3.
Complications
Comorbidity Group A (%) Group B (%)
Major Complication
  Deep infection   8 (7%)   1 (1%)
  Neurologic injury   1(1%)   -
  Pneumonia   1(1%)   -
  Myocardial infarction   -   -
  Renal failure   -   -
  Congestive heart failure   -   -
  Subtotal   10(9%)   1(1%)
Minor Complication
  Superficial infection   10(9%)   8(8%)
  Dura tear   14 (13%)   15 (14%)
  Ileus   19 (17%)   13 (13%)
  Urinary retension   9(8%)   3(3%)
  Urinary tract infection   -   -
  Screw loosening / breakage   -   -
  Subtotal   52 (47%)   39 (38%)
Total   62 (56%)   40 (39%)
Table 4.
Distribution of Patients Relevant to Outcome
Group Excellent Good Fair Poor Total
Group A 56 32 19 3 110
Group B 48 43 8 4 103
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