Top

European Spine Journal

Published in:

01-03-2012 | Original Article

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

Authors: Rolf Sobottke, Emin Aghayev, Christoph Röder, Peer Eysel, Stephan K. Delank, Thomas Zweig

Published in: European Spine Journal | Issue 3/2012

Abstract

Introduction

Published opinions regarding the outcomes and complications in older patients have a broad spectrum and there is a disagreement whether surgery in older patients entails a higher risk. Therefore this study examines the risk of surgery for lumbar spinal stenosis relative to age in the pooled data set of the Spine Tango registry.

Materials and methods

Between May 2005 and February 2010 the database query resulted in 1,764 patients. The patients were subdivided into three socio-economically relevant age groups: <65 years, 65–74 years, ≥75 years. Frequencies for occurred surgical, general and follow-up complications were assessed. Multivariate and univariate logistic regressions were performed to reveal predictors for respective complication types.

Results and discussion

Our study found that age, ASA status and blood loss were significant co-varieties for the occurrence of general complications. The risk of general complications is increased in older versus younger patients. Fusion or rigid stabilization does not lead to more complications. Surgical complications as well as complication rates at follow-up showed no significant age-related variation. Physician-based outcome was good or excellent in over 80% of patients in all age groups.

Arden NK, Price C, Reading I, Stubbing J, Hazelgrove J, Dunne C, Michel M, Rogers P, Cooper C (2005) A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study. Rheumatology (Oxford, England) 44:1399–1406CrossRef

Carreon LY, Puno RM, Dimar JR 2nd, Glassman SD, Johnson JR (2003) Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am. 85-A:2089–2092PubMed

Cassinelli EH, Eubanks J, Vogt M, Furey C, Yoo J, Bohlman HH (2007) Risk factors for the development of perioperative complications in elderly patients undergoing lumbar decompression and arthrodesis for spinal stenosis: an analysis of 166 patients. Spine 32:230–235PubMedCrossRef

Ciol MA, Deyo RA, Howell E, Kreif S (1996) An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc 44:285–290PubMed

Cloyd JM, Acosta FL Jr, Ames CP (2008) Complications and outcomes of lumbar spine surgery in elderly people: a review of the literature. J Am Geriatr Soc 56:1318–1327PubMedCrossRef

Daubs MD, Lenke LG, Cheh G, Stobbs G, Bridwell KH (2007) Adult spinal deformity surgery: complications and outcomes in patients over age 60. Spine 32:2238–2244PubMedCrossRef

Deyo RA, Cherkin DC, Loeser JD, Bigos SJ, Ciol MA (1992) Morbidity and mortality in association with operations on the lumbar spine: the influence of age, diagnosis, and procedure. J Bone Joint Surg 74:536–543PubMed

Deyo RA, Mirza SK (2006) Trends and variations in the use of spine surgery. Clin Orthop Relat Res 443:139–146PubMedCrossRef

Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332:556–561PubMedCrossRef

10.

Jonsson B, Annertz M, Sjoberg C, Stromqvist B (1997) A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: five-year follow-up by an independent observer. Spine 22:2938–2944PubMedCrossRef

11.

Katz JN (1995) Lumbar spinal fusion: surgical rates, costs, and complications. Spine 20:78S–83SPubMedCrossRef

12.

Kilincer C, Steinmetz MP, Sohn MJ, Benzel EC, Bingaman W (2005) Effects of age on the perioperative characteristics and short-term outcome of posterior lumbar fusion surgery. J Neurosurg Spine 3:34–39PubMedCrossRef

13.

Malter AD, McNeney B, Loeser JD, Deyo RA (1998) 5-year reoperation rates after different types of lumbar spine surgery. Spine 23:814–820PubMedCrossRef

14.

Martin BI, Mirza SK, Comstock BA, Gray DT, Kreuter W, Deyo RA (2007) Are lumbar spine reoperation rates falling with greater use of fusion surgery and new surgical technology? Spine 32:2119–2126PubMedCrossRef

15.

Melloh M, Staub L, Aghayev E, Zweig T, Barz T, Theis JC, Chavanne A, Grob D, Aebi M, Roeder C (2008) The international spine registry SPINE TANGO: status quo and first results. Eur Spine J 17:1201–1209PubMedCrossRef

16.

Okuda S, Oda T, Miyauchi A, Haku T, Yamamoto T, Iwasaki M (2006) Surgical outcomes of posterior lumbar interbody fusion in elderly patients. J Bone Joint Surg 88:2714–2720PubMedCrossRef

17.

Porter RW (1996) Spinal stenosis and neurogenic claudication. Spine 21:2046–2052PubMedCrossRef

18.

Raffo CS, Lauerman WC (2006) Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade. Spine 31:99–103PubMedCrossRef

19.

Ragab AA, Fye MA, Bohlman HH (2003) Surgery of the lumbar spine for spinal stenosis in 118 patients 70 years of age or older. Spine 28:348–353PubMed

20.

Roder C, Chavanne A, Mannion AF, Grob D, Aebi M (2005) SSE Spine Tango content, workflow, set-up. http://www.eurospine.org-Spine Tango. Eur Spine J 14:920-924

21.

Sanderson PL, Wood PL (1993) Surgery for lumbar spinal stenosis in old people. J Bone Joint Surg Br 75:393–397PubMed

22.

Shabat S, Arinzon Z, Folman Y, Leitner J, David R, Pevzner E, Gepstein R, Pekarsky I, Shuval I (2008) Long-term outcome of decompressive surgery for lumbar spinal stenosis in octogenarians. Eur Spine J 17:193–198PubMedCrossRef

23.

Silvers HR, Lewis PJ, Asch HL (1993) Decompressive lumbar laminectomy for spinal stenosis. J Neurosurg 78:695–701PubMedCrossRef

24.

Thome C, Zevgaridis D, Leheta O, Bazner H, Pockler-Schoniger C, Wohrle J, Schmiedek P (2005) Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg Spine 3:129–141PubMedCrossRef

25.

Zweig T, Mannion AF, Grob D, Melloh M, Munting E, Tuschel A, Aebi M, Roder C (2009) How to Tango: a manual for implementing Spine Tango. Eur Spine J 18(Suppl 3):312–320PubMedCrossRef

Title: Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry
Authors: Rolf Sobottke
Emin Aghayev
Christoph Röder
Peer Eysel
Stephan K. Delank
Thomas Zweig
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 3/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-2016-y

At a glance: The STEP trials

Springer Medicine

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

Abstract

Introduction

Materials and methods

Results and discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results and discussion

Please log in to get access to this content

Other articles of this Issue 3/2012

Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature

Thoracolumbar scoliosis posterior approach

The Fernstrom ball revisited

Hemivertebra resection in children, results after single posterior approach and after combined anterior and posterior approach: a comparative study

Trends over time in the size and quality of randomised controlled trials of interventions for chronic low-back pain

Cytokine inhibition and time-related influence of inflammatory stimuli on the hyperalgesia induced by the nucleus pulposus