International Orthopaedics

, Volume 40, Issue 6, pp 1067–1074 | Cite as

The incidence and risk factors for post-operative ileus after spinal fusion surgery: a multivariate analysis

  • Paul D. KielyEmail author
  • Lauren E. Mount
  • Jerry Y. Du
  • Joseph T. Nguyen
  • Gil Weitzman
  • Stavros Memstoudis
  • Seth A. Waldman
  • Darren R. Lebl
Original Paper



Post-operative ileus is a recognized complication of surgery. Little is known about the incidence and risk factors for post-operative ileus following spinal fusion surgery. To report the incidence and to assess for independent risk factors of post-operative ileus after spinal fusion surgery.


Retrospective single-centre cohort study. Patients with prolonged or recurrent post-operative ileus were identified by review of hospital stay documentation. Patients with post-operative ileus were matched 1:2 to a control cohort without post-operative ileus. Uni and multi variate analyses were performed on demographic, comorbidity, surgical indication, medication, and peri-operative details to identify risk factors for post-operative ileus.


Two thousand six hundred and twenty five patients underwent spinal fusion surgery between January 2012 and December 2012. Forty nine patients with post-operative ileus were identified (1.9 %). Post-operative length of hospital stay was significantly longer for patients with post-operative ileus (9.3 ± 5.2 days), than control patients (5.5 ± 3.2 days) (p < 0.001). Independent risk factors were Lactated Ringers solution (aOR: 2.12, p < 0.001), 0.9 % NaCl solution (aOR: 2.82, p < 0.001), and intra-operative hydromorphone (aOR: 2.31, p < 0.01) and a history of gastro-oesophageal reflux (aOR: 4.86, p = 0.03). Albumin administration (aOR: 0.09, p < 0.01) was protective against post-operative ileus.


Post-operative ileus is multifactorial in origin, and this study identified intra-operative hydromorphone and post-operative crystalloid fluid administration ≥2 litres as independent risk factors for the development of ileus.


Postoperative ileus Incidence Risk factors Spinal fusion 


Compliance with ethical standards


This study did not receive nor was funded by any grant.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© SICOT aisbl 2016

Authors and Affiliations

  • Paul D. Kiely
    • 1
    Email author
  • Lauren E. Mount
    • 2
  • Jerry Y. Du
    • 2
  • Joseph T. Nguyen
    • 2
  • Gil Weitzman
    • 2
  • Stavros Memstoudis
    • 2
  • Seth A. Waldman
    • 2
  • Darren R. Lebl
    • 2
  1. 1.Nicklaus Childrens HospitalMiamiUSA
  2. 2.Hospital for Special SurgeryNew YorkUSA

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