Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients

Background The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS). Methods A total of 1100 DLS patients who were older than 60 years were revi...

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Published in:BMC geriatrics Vol. 20; no. 1; pp. 301 - 7
Main Authors: Zhong, Weiyang, Liang, Xinjie, Luo, Xiaoji, Huang, Tianji, Quan, Zhengxue
Format: Journal Article
Language:English
Published: London BioMed Central 24.08.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Aged
Aging
Back surgery
Body mass index
Cohort analysis
Cohort Studies
Complications and side effects
Degenerative disc disease
Degenerative lumbar spondylolisthesis
Diabetes
Diabetes mellitus
Elderly patients
Female
Geriatrics
Geriatrics/Gerontology
Health services research
Humans
Infections
Internal fixation
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - surgery
Medical research
Medicine
Medicine & Public Health
Nonunion
Older people
Patients
Rehabilitation
Reoperation
Research Article
Retrospective Studies
Risk factor
Risk Factors
Spinal Fusion - adverse effects
Spine (lumbar)
Spondylolisthesis
Spondylolisthesis - diagnostic imaging
Spondylolisthesis - epidemiology
Spondylolisthesis - surgery
Surgeons
Surgery
Surgical outcomes
Treatment Outcome
Unplanned operation
Wound infection
Degenerative lumbar spondylolisthesis
Unplanned operation
Elderly patients
Risk factor
ISSN:1471-2318, 1471-2318
Online Access:Get full text
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Summary:Background The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS). Methods A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016. 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations. Results A total of 33 patients underwent unplanned reoperations (3%). The patients were followed up for an average of 4.20 ± 2.25 years (group A) and 4.32 ± 2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B. Conclusion Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.
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ISSN:1471-2318
1471-2318
DOI:10.1186/s12877-020-01717-2