Peri-operative complications of lumbar spine surgery in patients over eighty five years of age: a retrospective cohort study
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To compare peri-operative complication rates in ≥ 85-year-old patients who underwent decompression surgery with or without instrumented fusion for degenerative disorders.
This study involved 907 patients who underwent lumbar spine surgery for degenerative disorders between January 2006 and June 2012. Of these, 33 patients (3.6% of the entire population) were over 85 years of age (85–94 years). Decompression-alone and instrumentation groups were compared in terms of comorbidities, American Society of Anesthesiologists (ASA)-physical status (PS) class, peri-operative complications, and Japanese Orthopedic Association (JOA) scores.
Thirty-three ≥ 85-year-old patients underwent surgery. All were ASA-PS class 2 (94%) or 3. The decompression-alone (n = 19) and instrumentation (n = 14) groups did not differ in comorbidity (95 vs. 100%, P = 0.383) or ASA-PS class (P = 0.561). Both exhibited improved JOA scores (decompression-alone: 13.4/29 to 22.7/29; instrumentation: 8.6/29 to 17.9/29; P = 0.9068) and had similar peri-operative complication rates (21.0 vs. 28.5%, P = 0.374).
Although instrumentation is considered more invasive than decompression, we detected no statistically significant differences in peri-operative complication rates between these two types of surgery in ≥ 85-year-old patients. Surgeons should perform instrumentation even in the patients over 85 years with ASA class 3 or less.
KeywordsPerioperative complications Decompression Instrumentation surgery Elderly old patients Comorbidities ASA-PS classification
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
The study was approved by the clinical ethics committee of the Spine Center in XXXX Central General Hospital (approval number: 2017-4) and was conducted according to the 1964 Helsinki Declaration and its later amendments. All participants gave written informed consent.
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