European Spine Journal

, Volume 21, Issue 12, pp 2680–2687 | Cite as

Lumbar spine fusion surgery and stroke: a national cohort study

  • Jau-Ching Wu
  • Yu-Chun Chen
  • Laura Liu
  • Wen-Cheng Huang
  • Peck-Foong Thien
  • Tzeng-Ji Chen
  • Henrich Cheng
  • Su-Shun Lo
Original Article



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


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.


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.


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.


Cerebrovascular accident Hemorrhagic stroke Ischemic stroke Lumbar fusion 



International Classification of Disease, 9th Version


National Health Insurance


National Health Insurance Research Database


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jau-Ching Wu
    • 2
    • 3
    • 4
  • Yu-Chun Chen
    • 1
    • 8
  • Laura Liu
    • 5
    • 6
  • Wen-Cheng Huang
    • 2
    • 3
  • Peck-Foong Thien
    • 7
  • Tzeng-Ji Chen
    • 8
  • Henrich Cheng
    • 2
    • 3
    • 4
  • Su-Shun Lo
    • 9
  1. 1.Department of Medical Research and EducationNational Yang-Ming University HospitalI-LanTaiwan
  2. 2.Department of Neurosurgery, Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan
  3. 3.School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  4. 4.Institute of PharmacologyNational Yang-Ming UniversityTaipeiTaiwan
  5. 5.Department of OphthalmologyChang Gung Memorial HospitalTaoyuanTaiwan
  6. 6.College of MedicineChang Gung UniversityTaoyuanTaiwan
  7. 7.Department of PediatricsNational Yang-Ming University HospitalI-LanTaiwan
  8. 8.Institute of Hospital and Health Care Administration, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  9. 9.Department of Surgery, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan

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