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Bae, Kwak, and Chung: Lumbar Spinal Stenosis Accompanied by Severe Osteoarthritis of Knee - Comparison between Staged Operations and Same-day Operations -
Original Article

Journal of Korean Spine Surg 2006;13(4):292-298.

Published online: 21 February 2006

DOI: https://doi.org/10.4184/jkss.2006.13.4.292

Lumbar Spinal Stenosis Accompanied by Severe Osteoarthritis of Knee - Comparison between Staged Operations and Same-day Operations -

Sang Wook Bae, M.D., Ho Yoon Kwak, M.D., Joo Sun Chung, M.D.

Department of Orthopedic Surgery, Eulji Hospital, Eulji Medical University

Address reprint requests to Ho Yoon Kwak, M.D. Department of Orthopedic Surgery, Eulji Hospital, Eulji Medical University 280-1 Hagye Dong, Nowon Ku, 139-711, Seoul, Rep. of Korea Tel: 82-2-970-8256, Fax: 82-2-972-0068, E-mail: khy2401@eulji.or.kr

Copyright © 2006 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retrospective study.

Objective

To compare the perioperative morbidity of patients who undergo sameday operations for lumbar spinal stenosis accompanied by severe osteoarthritis of knee with those who undergo staged operations.

Summary and Literature Review

There is no report on the perioperative morbidity of sameday operations for patients who have a concurrent lumbar spinal stenosis and severe osteoarthritis of the knee, even though elective surgery for lumbar spinal stenosis or total knee arthroplasty are safe procedures.

Materials and Methods

From January 1996 to December 2005, 11 patients who underwent staged operations for lumbar spinal stenosis and concomitant osteoarthritis of the knee (Group I) and 14 patients who underwent total knee arthroplasty and lumbar spinal decompression and fusion on the sameday (Group II) were compared in terms of the operative time, blood loss, perioperative complications and admission days. The data was analyzed statistically using a chi-square test through SPSS v.10.0.

Results

The mean surgery time in groups I and II was 266 34.4 minutes and 258 54.2 minutes, respectively. The estimated blood loss during operation of groups I and II was 1055 229.6 and 925 174.0. There was no statistical differences between the two groups. There were no life-threatening complications in any group. The admission period for group I and group II were 41.0 6.05 days and 30.1 5.10 days respectively, but there was no statistical significance.

Conclusion

There was no difference in the surgical time, estimated blood loss, and complications between the group that underwent the staged operations and the group that underwent sameday operations. A possible surgical option is to perform both procedures on the same day.

Keywords: Same-day operation, Total knee arthroplasty, Spinal decompression and fusion

REFERENCES

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Table 1.
List of comorbidities
Simple hypertension
Heart disease
Congestive heart failure
Ischemic heart disease
Valvular heart disease
CVA history with or without hemiparesis
Chronic lung disease
Simple diabetes mellitus
Diabetes mellitus with complications
Liver disease
Nephropathy
Peripheral vascular disease including hypercholesterolemia
Parkinson's disease
Psychiatric problem
Cancer
Organic brain syndrome
Miscellaneous
Table 2.
Preoperative physical status classification of patients according to the American Society of Anesthesiologists
1 A normal healthy patient
2 A patient with mild systemic disease and no functional limitation
3 A patient with moderate to severe systemic disease that results in some functional limitation
4 A patient with severe systemic disease that is a constant threat to life and functionally incapacitating
5 A moribund patient who is not expected to survive 24 hours with or without surgery
6 A brain-dead patient whose organs are being harvested
E If the procedure is an emergency, the physical status is followed by E (for example “2E”)
Table 3.
Patients who underwent staged operations
Number Age Sex ASA score HSS Knee score Level of fusion Operation time Blood loss (CC) Complications Hospital stay (Days)
1 60 F 2 30 2 230 1100 tourniquet pain 42
2 64 F 3 40 2 240 1000 39
3 70 F 2 46 2 240 1900 fever, urination difficulty 42
4 77 F 2 40 2 260 1100 deep vein thrombosis 43
5 65 F 3 45 1 240 1800 29
6 61 F 2 49 2 270 1000 tourniquet pain 42
7 62 F 2 61 3 325 1600 fever 51
8 57 F 3 46 1 230 1800 paralytic ileus 32
9 69 F 1 38 2 300 1000 superficial infection 46
10 71 F 2 39 3 310 1300 feve 42
11 62 F 2 25 2 290 1000 43
Table 4.
Patients who underwent sameday operations
Number Age Sex ASA score HSS Knee score Level of fusion Operation time Blood loss (CC) Complications Hospital stay (Days)
1 64 F 2 49 2 250 1900 29
2 57 F 2 46 1 160 1700 27
3 69 F 2 53 3 26 1000 fever 36
4 61 F 3 42 2 240 1850 tourniquet pain 30
5 70 F 3 39 2 290 1900 paralytic ileus 28
6 64 F 2 48 1 240 1800 32
7 67 F 2 60 2 200 1800 superficial infection 25
8 64 F 2 39 3 315 1100 31
9 77 F 2 35 2 270 1800 meralgia paresthetica 25
10 61 F 3 43 2 240 1000 23
11 64 F 3 32 1 200 1800 28
12 69 F 2 39 3 340 1300 fever, urination difficulty 42
13 70 F 2 36 3 340 1200 atelectasis 30
14 65 F 2 48 2 260 1800 36
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