Lee Jung-Hyun, Chun Hyoung-Joon, Yi Hyeong-Joong, Bak Koang Hum, Ko Yong, Lee Yoon Kyoung
Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
J Korean Neurosurg Soc. 2012 Jun;51(6):350-8. doi: 10.3340/jkns.2012.51.6.350. Epub 2012 Jun 30.
Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea.
We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed.
In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved).
Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.
人类预期寿命显著增加，随之而来的是腰椎疾病患者数量大幅上升。有症状的腰椎疾病即使在老年人中也应进行治疗，对于中度至重度腰椎疾病需要进行诸如融合手术等外科手术。然而，融合手术会伴随各种围手术期并发症。本研究的目的是检查围手术期并发症，并评估与腰椎融合相关的风险因素，重点关注韩国至少70岁的老年患者。
我们回顾性调查了2003年至2007年在我院接受腰椎融合手术的489例各种腰椎疾病患者。本研究分析了三种融合手术方式及融合节段数量。还对慢性病进行了评估。分析了并发症的风险因素及其与年龄的关联。
在本研究中，74例患者出现并发症（15%）。70岁及以上患者的围手术期并发症发生率显著高于其他年龄组（单因素分析，p = 0.001；多因素分析，p = 0.004）。然而，围手术期并发症与所测试的其他因素（性别、合并症、手术方式、融合节段）无显著关联。
年龄增长是接受腰椎融合手术患者围手术期并发症的重要风险因素，而其他因素不显著。我们建议对接受腰椎融合手术的老年患者进行良好的临床判断并谨慎选择。
