Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Neurosurgery. 2011 Apr;68(4):897-902; discussion 902. doi: 10.1227/NEU.0b013e3182098bfa.
The number of spine operations performed in the elderly population is rising.
To identify and describe perioperative and postoperative complications in patients 70 years and older who have undergone minimally invasive lumbar interbody spine fusion.
A retrospective analysis was performed on 66 consecutive patients aged 70 years or older who underwent a minimally invasive interbody lumbar fusion. Electronic medical records were analyzed for patient demographics, procedures, and perioperative and postoperative complications.
Between 2000 and 2009, 66 patients with an average age of 74.9 years (range, 70-86 years) underwent 68 lumbar interbody fusions procedures. The mean follow-up was 14.7 months (range, 1.5-50 months). The minimally invasive approaches included 41 cases of extreme lateral interbody fusion and 27 minimally invasive transforaminal lumbar interbody fusions. We observed 5 major (7.4%) and 17 minor (25%) complications. The 5 major complications consisted of 4 cases of interbody graft subsidence and 1 adjacent level disease. There were no intraoperative medical complications. There were no myocardial infarctions, pulmonary embolisms, hardware complications requiring removal, wound infections, major visceral, vascular, neural injuries, or death in the study period.
Minimally invasive interbody fusions can be performed in the elderly (ages 70 years and older) with an overall low rate of major complications. Graft subsidence in this population when not supplemented with posterior instrumentation is a concern. Age should not be a deterrent to performing complex minimally invasive interbody fusions in the elderly.
在老年人群中进行的脊柱手术数量正在增加。
确定并描述行微创腰椎体间融合术的 70 岁及以上患者的围手术期和术后并发症。
对 2000 年至 2009 年间 66 例 70 岁及以上行微创腰椎体间融合术的连续患者进行回顾性分析。对电子病历进行分析，包括患者人口统计学、手术和围手术期及术后并发症。
在 66 例患者中，平均年龄为 74.9 岁（70-86 岁），平均随访 14.7 个月（1.5-50 个月）。微创入路包括 41 例极外侧腰椎体间融合术和 27 例微创经椎间孔腰椎体间融合术。我们观察到 5 例主要（7.4%）和 17 例次要（25%）并发症。5 例主要并发症包括 4 例椎间植骨沉降和 1 例相邻节段疾病。术中无医疗并发症。在研究期间，无心肌梗死、肺栓塞、需要取出的硬件并发症、伤口感染、主要内脏、血管、神经损伤或死亡。
微创腰椎体间融合术可在老年患者（70 岁及以上）中进行，总体主要并发症发生率较低。在未行后路固定的情况下，该人群的植骨沉降是一个问题。年龄不应成为在老年患者中施行复杂微创腰椎体间融合术的障碍。
