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Lumbar spine fusion surgery and stroke: a national cohort study

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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.

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Abbreviations

ICD-9:

International Classification of Disease, 9th Version

NHI:

National Health Insurance

NHIRD:

National Health Insurance Research Database

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Acknowledgments

This study was based partly on data from the NHRI database provided by the BNHI, Department of Health, and managed by NHRI in Taiwan. The interpretation and conclusions contained herein do not represent those of the BNHI, the Department of Health, or NHRI.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medical Research and Education, National Yang-Ming University Hospital, No. 152, Xin Min Rd, 26042, I-Lan, Taiwan

    Yu-Chun Chen

  2. Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Jau-Ching Wu, Wen-Cheng Huang & Henrich Cheng

  3. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Jau-Ching Wu, Wen-Cheng Huang & Henrich Cheng

  4. Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan

    Jau-Ching Wu & Henrich Cheng

  5. Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Laura Liu

  6. College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Laura Liu

  7. Department of Pediatrics, National Yang-Ming University Hospital, I-Lan, Taiwan

    Peck-Foong Thien

  8. Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Yu-Chun Chen & Tzeng-Ji Chen

  9. Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Su-Shun Lo

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  1. Jau-Ching Wu
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  2. Yu-Chun Chen
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Correspondence to Yu-Chun Chen.

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Wu, JC., Chen, YC., Liu, L. et al. Lumbar spine fusion surgery and stroke: a national cohort study. Eur Spine J 21, 2680–2687 (2012). https://doi.org/10.1007/s00586-012-2405-x

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  • DOI: https://doi.org/10.1007/s00586-012-2405-x

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