Abstract

BackgroundThe Japanese Society for Spine Surgery and Related Research (JSSR) previously carried out two nationwide surveys in 1994 and 2001 on complications from spine and spinal cord surgery. More than 10 years have now elapsed since 2001. Rapidly ageing populations have major impacts on society, particularly in the medical field. The purpose of this study was therefore to examine the present situation for spine surgery in Japan.MethodsThe JSSR research team prepared a computerized questionnaire made up of two categories in order to capture clinicopathological information and surgical information. A recordable optical disc for data storage was sent to surgeons who were certified for spine surgery by JSSR. The data was analyzed.ResultsThe JSSR carried out a nationwide survey of complications of 31,380 patients. Patients aged 60 years or older comprised 63.1 % of the overall cohort. This was considerably higher than observed in previous surveys. Degenerative spinal diseases increased 79.7 %. With regard to surgical approach, the incidence of anterior surgery has decreased, while that of posterior surgery has increased compared to the earlier surveys (both p < 0.05). Spinal instrumentation was applied in 30.2 % cases, compared to 27.0 and 34.0 % cases in the 1994 and 2001 surveys, respectively. Intraoperative and postoperative complications were reported in 10.4 % and were slightly increased compared to 8.6 % in the earlier surveys (both p < 0.05). Diseases associated with a high incidence of complication included intramedullary tumor (29.3 %) and primary malignant tumor (22.0 %). The highest incidence of complication was dural tear (2.1 %), followed by neurological complication (1.4 %).

Highlights

  • The practice of spine surgery has undergone rapid changes in Japan

  • The certified surgeons were distributed in 750 institutions nationwide and a response was achieved from 209 institutions

  • We reviewed the preoperative factors of diabetes mellitus (DM), dialysis, corticosteroid use, disease-modifying anti-rheumatic drug (DMARD) therapy involving biologic therapy, Parkinson’s disease, age and body mass index (BMI)

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Summary

Introduction

A. Okawa Section of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan. K. Otani Department of Orthopaedic Surgery, Faculty of Medicine, Fukushima Medical University, School of Medicine, Fukushima, Japan. The Japanese Society for Spine Surgery and Related Research (JSSR) previously carried out two nationwide surveys in 1994 and 2001 on complications from spine and spinal cord surgery. Patients aged 60 years or older comprised 63.1 % of the overall cohort. This was considerably higher than observed in previous surveys. With regard to surgical approach, the incidence of anterior surgery has decreased, while that of posterior surgery has increased compared to the earlier surveys (both p < 0.05). The highest incidence of complication was dural tear (2.1 %), followed by neurological complication (1.4 %)

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