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Abstract
Objectives
To assess the operative risks and complications of posterior decompression and fusion for degenerative spine disorders, we compared single level posterior decompression and posterolateral fusion of lumbar spine with total hip arthroplasty which have been evaluated in many reports and articles on complications and operative risks.
Summary of Literature Review
There has been no study comparing the relative risks of spinal surgery with total hip arthroplasty.
Materials and Methods
One hundred and thirty-six subjects (mean age 69.6 years) who received single level posterior decompression and posterolateral fusion for degenerative lumbar disorders from February 2000 to May 2010 were selected as group A, and 136 subjects (mean age 67.2 years) who received total hip arthroplasty during the same period were selected as group B. A comparative analysis was performed according to age, gender, pre-operative ASA status based on their underlying medical conditions, total operative time, blood loss, hospitalization period, incidence of major and minor complications and functional recovery at the time of final follow up using retrospective and statistical manners from medical records and radiologic evaluations.
Results
The total operative time and blood loss were longer in group A with statistical significance (P<0.01). Major complications were frequent in group B with 16 cases and in group A with 6 cases (P<0.05). There were no significant differences in the total hospitalization period, incidence of minor complications and postoperative functional recovery.
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Table 1.
Comparative analysis between group A and group B
| Group A (N∗=136) | Group B (N=136) | P-value | |
|---|---|---|---|
| Gender | |||
| Male | 56 | 62 | 0.463 |
| Female | 80 | 74 | |
| ASA | |||
| I | 24 | 24 | |
| II | 86 | 78 | 0.691 |
| III | 14 | 18 | |
| IV | 12 | 16 | |
| Average operative time(min) | 127.6±12.3 | 85.2±11.6 | <0.01 |
| Average blood loss(ml) | 1052.3±625.5 | 503.6±145.2 | <0.01 |
| Complication | |||
| Major | 6 | 16 | 0.026 |
| Minor | 18 | 10 | 0.110 |
| Clinical outcome | |||
| Excellent | 62 | 72 | |
| Good | 54 | 50 | 0.552 |
| Poor | 18 | 12 | |
| Fair | 2 | 2 |
Table 2.
Detail analysis of postoperative complication between group A and group B
| Group A (N∗=136) | Group B (N=136) | P-value | |
|---|---|---|---|
| Major complication(N) | 6 | 16 | 0.026 |
| Neurologic deficit | 0 | 0 | - |
| Deep wound infection | 4 | 4 | 1.0 |
| Pneumonia | 2 | 10 | 0.018 |
| Pulmonary embolism | 0 | 0 | - |
| Acute myocardial infarction | 0 | 2 | 0.156 |
| Acute renal failure | 0 | 0 | - |
| Minor complication(N) | 18 | 10 | 0.110 |
| Superficial wound infection | 3 | 2 | 0.652 |
| Ileus | 7 | 2 | 0.090 |
| Acute gastritis | 0 | 1 | 0.316 |
| UTI | 2 | 1 | 0.562 |
| Urinary retention | 3 | 1 | 0.314 |
| Transient delirium | 3 | 3 | 1.0 |
| Total(N) | 24 | 26 | 0.754 |
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