Complications and outcomes of surgery for degenerative lumbar deformity in elderly patients

Abstract

Hyo Jong Kim, Kyu Yeol Lee, Lih WangDepartment of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, KoreaBackground: The purpose of this study was to analyze the complications, clinical outcomes, and any correlative risk factors associated with degenerative lumbar deformity surgery in elderly patients.Methods: We reviewed 78 patients who underwent posterior decompression and posterolateral fusion requiring a minimum three-level fusion for degenerative lumbar deformity associated with spinal stenosis between May 2001 and May 2006, with at least a one-year follow-up period. We assessed and compared the postoperative complications and clinical outcomes for patients aged 65 years and over (group A) and patients aged 50–64 years (group B). Risk factors that could influence complications and clinical outcome were evaluated and statistically analyzed.Results: The postoperative complication rate was not significantly different between the two age groups (53% in group A and 40% in group B); however, group A had a significantly higher frequency of minor complications than group B, especially for urinary retention and postoperative delirium. A statistical relationship between diabetes mellitus and deep wound infection, one of the major complications of degenerative lumbar deformity surgery, was observed in both group A and group B. Male sex was a risk factor for urinary retention and long operative time, and abundant blood loss was a significant risk factor for postoperative delirium in group A.Conclusion: There were no significant differences in results for degenerative lumbar deformity surgery between patients older and younger than 65 years. However, diabetes mellitus showed a significant correlation with deep wound infection, which is one of the major complications of degenerative lumbar deformity surgery, and with urinary retention and postoperative delirium, which occurred frequently in patients aged older than 65 years.Keywords: spinal stenosis, lumbar deformity, elderly, risk factor, complication, clinical outcome