-
- Varun Puvanesarajah, Jourdan M Cancienne, Brian C Werner, Amit Jain, Anuj Singla, Adam L Shimer, Francis H Shen, and Hamid Hassanzadeh.
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD.
- Spine. 2018 Jan 1; 43 (1): 16-21.
Study DesignA retrospective database review.ObjectiveThe aim of this study was to compare the occurrence of complications in patients treated with one to two-level, three to seven-level, and more than eight level fusions.Summary Of Background DataElderly patients constitute a rapidly growing demographic with an increasing need for spinal procedures. Complication rates for spinal surgery in elderly patients range from 37% to 80% with major complications occurring in 12% to 21% of patients.MethodsThe PearlDiver database (2005-2012) was utilized to compare perioperative complication rates in patients aged 65 years and older undergoing posterolateral fusion of one to two (n = 90,527); three to seven (n = 23,827), and more than eight (n = 2758) thoracolumbar levels. Cohorts were matched by demographics and comorbidities. Ninety-day medical and surgical complication and mortality rates were determined.ResultsIn the full, unmatched cohort, the major complication rate was 15.9%, with matched cohorts of one to two, three to seven, and eight-level fusions associated with major complication rates of 12.5%, 20.5%, and 35.4%, respectively. Patients treated with 8+ level fusions had 3.8 and 2.1 times greater odds of developing a major complication than patients treated with 1 to 2 and 3 to 7-level fusions, respectively (P < 0.0001). Patients treated with more than eight-level fusions had 3.9 and 10.8 times increased odds of experiencing mortality than those treated with three to seven-level and one to two-level fusions, respectively.ConclusionElderly patients treated with spine fusions spanning more than eight levels experience significantly increased complication rates when compared with patients treated with fusions of shorter length.Level Of Evidence3.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.