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Perioperative complications and adverse events after lumbar spinal surgery: evaluation of 1012 operations at a single center

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Lumbar surgery and associated complications are increasing as society is aging. However, definitions of complications after lumbar surgery have not been established and previous reports have varied in the definition of, and focus on, intraoperative or major postoperative complications. We analyzed the frequency and severity of perioperative complications and all minor adverse events in lumbar surgery at a single center.

Methods

We retrospectively reviewed all lumbar surgery, including decompression surgery with or without fusion, at Meijo Hospital over a 10-year period. Perioperative complications and all surgery-related adverse events until 1 month postoperatively were reviewed for 1012 operations on 918 patients (average age 54 years old). The incidence of intraoperative complications was compared between junior (<10 years experience of spine surgery) and senior (≥10 years experience) surgeons.

Results

Perioperative complications and adverse events occurred in 159 operations (15.7%) on 127 patients (13.8%). There were a variety of perioperative adverse events, including digestive problems. Of the 159 complications and events, 24 (2.4%) were intraoperative and 135 (13.3%) were postoperative. Incidence of intraoperative complications was not significantly higher for junior surgeons; however, the operations performed by senior surgeons were significantly more invasive. Complications were more frequent in elderly patients (p < 0.01) and in operations that were longer (p < 0.0001), had greater estimated blood loss (p < 0.0001), and involved use of spinal instrumentation (p < 0.0001). Psychotic symptoms occurred significantly more often in older patients (p < 0.001).

Conclusion

The absence of a relationship between the experience of the surgeon and incidence of intraoperative complications may be because of the greater effect of invasive surgery. Although age and invasiveness were associated with more perioperative adverse events, we do not conclude that major surgery should be avoided for elderly patients. In contrast, careful focus on the surgical indication and procedure is required for these patients.

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Acknowledgments

The authors thank Ms Keiko Ogura for her assistance throughout this study.

Conflict of interest

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan

    Shiro Imagama & Naoki Ishiguro

  2. Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, 1-3-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan

    Noriaki Kawakami, Taichi Tsuji & Tetsuya Ohara

  3. Department of Orthopaedic Surgery, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan

    Yuji Matsubara

  4. Department of Orthopaedic Surgery, Konan Kosei Hospital, 46 Nobaku, Nobaku-cho, Konan, Aichi, 483-8202, Japan

    Tokumi Kanemura

  5. Goto Hospital and Spine Center, 4-10-2 Sakuragi-dori, Toyokawa, Aichi, 442-0027, Japan

    Manabu Goto

  6. Department of Orthopaedic Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 466-8650, Japan

    Yoshito Katayama

Authors
  1. Shiro Imagama
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  2. Noriaki Kawakami
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  7. Manabu Goto
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  8. Yoshito Katayama
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  9. Naoki Ishiguro
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Corresponding author

Correspondence to Shiro Imagama.

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Imagama, S., Kawakami, N., Tsuji, T. et al. Perioperative complications and adverse events after lumbar spinal surgery: evaluation of 1012 operations at a single center. J Orthop Sci 16, 510–515 (2011). https://doi.org/10.1007/s00776-011-0123-6

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  • DOI: https://doi.org/10.1007/s00776-011-0123-6

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