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KMID : 0388720090160010017
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Journal of Korean Society of Spine Surgery
2009 Volume.16 No. 1 p.17 ~ p.23
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Complication and Treatment Outcome of Degenerative Spinal Deformity Surgery in Elderly Patients
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Lee Sung-Won
Lee Kyu-Yeol
Sohn Sung-Keun
Wang Lih
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Abstract
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Study Design: A retrospective study
Objective: To analyze the complications, clinical outcome and any correlative risk factors of degenerative spinal deformity surgery in elderly patients.
Summary Of Literature Review: There is some controversy regarding the postoperative complications and the factors influencing them in the elderly patients who had undergone degenerative spinal deformity surgery.
Materials and Methods: Seventy eight patients, who underwent posterior decompression and posterolateral fusion requiring a minimum 3 level fusion for a degenerative spinal deformity associated with spinal stenosis between May, 2001 and May, 2006, were reviewed after a follow-up period of at least 1 year. This study compared the postoperative complications and clinical outcomes of patients over 65 years (group A) with patients between 50~64 years (group B). The risk factors that could influence the complications and clinical outcomes were evaluated and analyzed statistically.
Results: The postoperative complication rate was 53% in group A and 40% in group B without statistical significance. However, group A had a significantly higher frequency of minor complications than group B, particularly in urinary retention and postoperative delirium. There was an association between diabetes and deep wound infection as a major complication in groups A and B. Being male was a risk factor for urinary retention and longer surgery time, and abundant blood loss was significant risk factors for postoperative delirium in group A.
Conclusion: There were no significant differences in the treatment result for degenerative spinal deformity between patients older than 65 and younger than 65. It is considered that the blood sugar should be controlled strictly before and after surgery, and appropriate management is needed for postoperative delirium and urinary retention in elderly patients.
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KEYWORD
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Spinal deformity, Elderly patient, Complication, Clinical outcome
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