Perioperative complications of posterior lumbar decompression and arthrodesis in older adults
Perioperative complications of posterior lumbar decompression and arthrodesis in older adults
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DOI：
10.2106/00004623-200311000-00004
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发表时间：
2003-11-01
影响因子：
5.3
通讯作者：
Johnson, JR
中科院分区：
文献类型：
--
作者：
Carreon, LY;Puno, RM;Johnson, JR
背景：腰椎关节融合术通常用于老年患者治疗退行性脊柱问题。由于年龄和相关的医疗条件，这些患者发生并发症的风险可能会增加。在这项研究中，我们研究了65岁及以上患者后路腰椎减压和关节融合术围手术期并发症的发生率。方法：我们回顾了1993年至1995年间，98例65岁或65岁以上的脊柱退行性疾病的后路减压和腰椎关节融合术。平均年龄为72岁（65 - 84岁）。结果：78例患者出现围手术期并发症。21例患者至少有一种主要并发症，69例患者至少有一种轻微并发症。49例患者有不止一种并发症。最常见的主要并发症是伤口感染（患病率，10%），最常见的次要并发症是尿路感染（患病率，34%）。并发症发生率随年龄增大、出血量增加、手术时间延长、关节融合术节段数增加而增加。结论：外科医生应警惕行多节段腰椎减压联合固定术的老年患者围手术期并发症。老年患者应该意识到，由于他们的年龄，他们手术并发症的风险增加。注意控制失血，限制手术时间。证据等级：预后研究，II-1级（回顾性研究）。有关证据水平的完整描述，请参见作者说明。
Background: Lumbar arthrodesis is commonly done in elderly patients to treat degenerative spine problems. These patients may be at increased risk for complications because of their age and associated medical conditions. In this study, we examined the rates of perioperative complications associated with posterior lumbar decompression and arthrodesis in patients sixty-five years of age or older.Methods: We reviewed the hospital records of ninety-eight patients who were sixty-five years of age or older when they had a posterior decompression and lumbar arthrodesis with instrumentation, between 1993 and 1995, to treat degenerative disease of the spine. The average age was seventy-two years (range, sixty-five to eighty-four years).Results: Perioperative complications occurred in seventy-eight patients. Twenty-one patients had at least one major complication, and sixty-nine had at least one minor complication. Forty-nine patients had more than one complication. The most common major complication was wound infection (prevalence, 10%), and the most common minor complication was urinary tract infection (prevalence, 34%). The complication rate increased with older age, increased blood loss, longer operative time, and the number of levels of the arthrodesis.Conclusions: Surgeons should be vigilant about perioperative complications in elderly patients treated with multi-level lumbar decompression and arthrodesis with instrumentation. Elderly patients should be made aware that they are at increased risk for surgical complications because of their age. Attention should be paid to controlling blood loss and limiting operative time.Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.