European Spine Journal

, Volume 21, Issue 12, pp 2680–2687

Lumbar spine fusion surgery and stroke: a national cohort study

Authors

  • Jau-Ching Wu
    • Department of Neurosurgery, Neurological InstituteTaipei Veterans General Hospital
    • School of MedicineNational Yang-Ming University
    • Institute of PharmacologyNational Yang-Ming University
    • Department of Medical Research and EducationNational Yang-Ming University Hospital
    • Institute of Hospital and Health Care Administration, School of MedicineNational Yang-Ming University
  • Laura Liu
    • Department of OphthalmologyChang Gung Memorial Hospital
    • College of MedicineChang Gung University
  • Wen-Cheng Huang
    • Department of Neurosurgery, Neurological InstituteTaipei Veterans General Hospital
    • School of MedicineNational Yang-Ming University
  • Peck-Foong Thien
    • Department of PediatricsNational Yang-Ming University Hospital
  • Tzeng-Ji Chen
    • Institute of Hospital and Health Care Administration, School of MedicineNational Yang-Ming University
  • Henrich Cheng
    • Department of Neurosurgery, Neurological InstituteTaipei Veterans General Hospital
    • School of MedicineNational Yang-Ming University
    • Institute of PharmacologyNational Yang-Ming University
  • Su-Shun Lo
    • Department of Surgery, School of MedicineNational Yang-Ming University
Original Article

DOI: 10.1007/s00586-012-2405-x

Cite this article as:
Wu, J., Chen, Y., Liu, L. et al. Eur Spine J (2012) 21: 2680. doi:10.1007/s00586-012-2405-x

Abstract

Purpose

To investigate the incidence and risk of stroke after lumbar spinal fusion surgery.

Method

Study subjects were identified from a nationwide cohort of 1 million people from 2000 to 2005 and were divided into the lumbar spinal fusion group (n = 2,015), who received posterior lumbar spinal fusion surgery, and the comparison group (n = 16,120) composed of age-, sex-, and propensity score-matched control subjects. The matching process was intended to adjust for demographics, comorbidities, and other immeasurable covariates to minimize selection bias. All subjects were followed up for 3 years for stroke, including hemorrhagic and ischemic strokes. Kaplan–Meier and Cox regression analyses were performed.

Results

The overall incidence rate of stroke in the cohort was 9.99 per 1,000 person-year. The lumbar spinal fusion group was less likely to have any stroke (adjusted hazard ratio (HR) = 0.83, p = 0.293), hemorrhagic stroke (adjusted HR = 0.74, p = 0.739) and ischemic stroke (adjusted HR = 0.81, p = 0.250) than the comparison group, but without significance.

Conclusions

Three years post-operatively, patients who received lumbar spinal fusion had stroke incidence rates similar to those without surgery. Posterior lumbar spinal fusion surgery is not associated with increased risks for any kind of stroke.

Keywords

Cerebrovascular accident Hemorrhagic stroke Ischemic stroke Lumbar fusion

Abbreviations

ICD-9

International Classification of Disease, 9th Version

NHI

National Health Insurance

NHIRD

National Health Insurance Research Database

Copyright information

© Springer-Verlag 2012