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Clinical Analysis of Complications of Lumbar Spinal Stenosis in Elderly Patients with Lumbar Spinal Stenosis |
HE Yubao, XU Lin, REN Longxi, et al |
Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing Chaoyang District 100022, China |
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Abstract Objective: To analyze the influencing factors and incidence of complications after lumbar internal fixation in elderly patients with lumbar spinal stenosis, and to explore the relevant measures to reduce the complications. Methods: Patients aged 60 years and above with one or more comorbidities operated by multilevel instrumented lumbar fusion in our center between January 2012 and December 2013 were included in the study. Perioperative complications and their incidence were calculated. Age, number of levels fused, operative time, blood loss, and complication rates were correlated with the duration of stay and the incidence of perioperative complications using SPSS software. Measures to reduce complications are determined by these results and by review of literature. Results: Fifty two patients were included in the study (28 females and 24 males) with an average age of 69 years (range 60-84 years). Hypertension was the most common comorbidity followed by diabetes. Spondylolisthesis was the most common indication. Eleven complications were noted with an incidence of 21%. Three were systemic complications which required transfer to Intensive Care Unit. Local complications were incidental durotomy (three), transient root deficits (two), wound infections (one), and persistent radicular pain (two). Operative time and blood loss were significantly higher in patients with complications. Conclusion: The incidence of complications was strongly correlated with blood loss and operation time. The application of tranexamic acid, bone knife laminectomy, bilateral exposure and operation can reduce the operation time and bleeding volume, and help to reduce complications.
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