Journal of Korean Society of Geriatric Neurosurgery 2011;7(2):109-114.
Published online September 30, 2011.
Surgical Treatment for Degenerative Lumbar Diseases in Elderly Patients : Postoperative Complication and Risk Factor
Jun Seok Lee , In Ho Han , Byung Kwan Choi , Chang Hwa Choi
Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
노인 환자에서 퇴행성 요추 질환의 수술적 치료 : 수술 후 합병증과 위험인자
부산대학교 의학전문대학원 신경외과학교실
The aims of our study were to evaluate surgical outcome and postoperative complication and to know risk factors of major and minor complications of surgical treatment for degenerative lumbar spinal diseases in elderly patients.
We retrospectively reviewed the medical records of 137 patients older than 65 years who underwent surgical treatment for degenerative spinal diseases from January 2000 to June 2009. We evaluated the clinical outcome according to Macnab classification at final follow-up and postoperative complications (major and minor). In addition, the relationship between postoperative complications and pre- and intraoperative factors was investigated by statistical analysis using logistic regression.
At final follow-up, the clinical outcome showed excellent in 18 patients (13.1%), good in 96 (70.1%), fair in 20 (14.6%), poor in 3 (2.2%). Major complications occurred in 13 patients (9.5%) and minor complications occurred in 48 (35.0%). Two patients were dead due to sepsis and acute renal failure (mortality: 1.5%). The occurrence of major complications was significantly associated with high ASA grade (p=0.029). The occurrence of major complications was associated with long operative time (p=0.012) and fusion surgery (p=0.025).
Major complication occurred in 9.5% of the patients and mortality rate was 1.5%. Especially, high ASA grade was the risk factor of major complications and long operative time and fusion operation were the risk factors of minor complications. Therefore, we suggest that complication rate can be reduced if we try to minimize surgery and consider carefully co-morbidities in elderly patients.
Key Words: ElderlyㆍDegenerative lumbar diseasesㆍSurgeryㆍComplication

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