Early postoperative complications after elective degenerative lumbar spine surgery in elderly patients

Abstract

Object: Degenerative lumbar spine disease is an increasing problem nowadays, affecting unceasingly more people, especially, the elderly population. The older age of patients is generally associated with a higher rate of postoperative complications. Methods: A retrospective analysis of patients aged 60 years or older who underwent the elective spine surgery at the Clinic of Neurosurgery at the University hospital Martin from January 2015 to December 2016. Authors assessed the incidence of early postoperative complications after lumbar spine surgery in older patients and conducted to determine a correlation between comorbidities, selected risk factors and the occurrence of postoperative complications. Results: Overall, 107 patients were assessed (46 men and 59 women). The incidence of postoperative complications was 24.3%. The incidence of major complications was 9.35 %, the incidence of minor complications was 17.76%. 7.5% of patients needed a revision surgery. 83.2% of patients underwent decompressive surgery alone while, 16.8% of patients underwent spinal surgery with fusion. The rate of complications was higher in those patients who underwent surgery with instrumentation in comparison to the decompressive surgery alone (23.6% vs. 27.8%; p = 0.7561). There was a statistically significant association between the presence of type II diabetes mellitus and the incidence of complications (p = 0.0082). The length of a surgical procedure strongly affected the occurrence of postoperative complications (p = 0,000013). Conclusion: Almost one quarter of patients developed postoperative complications with the predominance of minor complications. This study showed an increasing rate of complications in patients who underwent a surgical procedure with instrumentation than in patients with a decompressive surgery only, but without statistical significance. We proved an association between the operation time, the length of the hospital stay, the presence of type II diabetes mellitus and the presence of postoperative complications.