Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis

Clinical article

Restricted access

Object

The purpose of this study was to evaluate the prospectively collected Scoliosis Research Society (SRS) database to assess the incidences of morbidity and mortality (M&M) in the operative treatment of degenerative lumbar stenosis, one of the most common procedures performed by spine surgeons.

Methods

All patients who underwent surgical treatment for degenerative lumbar stenosis between 2004 and 2007 were identified from the SRS M&M database. Inclusion criteria for analysis included an age ≥ 21 years and no history of lumbar surgery. Patients were treated with either decompression alone or decompression with concomitant fusion. Statistical comparisons were performed using a 2-sided Fisher exact test.

Results

Of the 10,329 patients who met the inclusion criteria, 6609 (64%) were treated with decompression alone, and 3720 (36%) were treated with decompression and fusion. Among those who underwent fusion, instrumentation was placed in 3377 (91%). The overall mean patient age was 63 ± 13 years (range 21–96 years). Seven hundred nineteen complications (7.0%), including 13 deaths (0.1%), were identified. New neurological deficits were reported in 0.6% of patients. Deaths were related to cardiac (4 cases), respiratory (5 cases), pulmonary embolus (2 cases), and sepsis (1 case) etiologies, and a perforated gastric ulcer (1 case). Complication rates did not differ based on patient age or whether fusion was performed. Minimally invasive procedures were associated with fewer complications and fewer new neurological deficits (p = 0.01 and 0.03, respectively).

Conclusions

The results from this analysis of the SRS M&M database provide surgeons with useful information for preoperative counseling of patients contemplating surgical intervention for symptomatic degenerative lumbar stenosis.

Abbreviations used in this paper: IRB = institutional review board; M&M = morbidity and mortality; SRS = Scoliosis Research Society.

Article Information

Current affiliation for Dr. Sansur: Department of Neurosurgery, University of Maryland, Baltimore, Maryland.

Address correspondence to: Christopher I. Shaffrey, M.D., Department of Neurosurgery, University of Virginia Health System, P.O. Box 800212, Charlottesville, Virginia 22908. email: cis8z@hscmail.mcc.virginia.edu.

© AANS, except where prohibited by US copyright law.

Headings

References

1

Amundsen TWeber HNordal HJMagnaes BAbdelnoor MLilleâs F: Lumbar spinal stenosis: conservative or surgical management?: A prospective 10-year study. Spine 25:142414362000

2

Arinzon ZHFredman BZohar EShabat SFeldman JSJedeikin R: Surgical management of spinal stenosis: a comparison of immediate and long term outcome in two geriatric patient populations. Arch Gerontol Geriatr 36:2732792003

3

Atlas SJKeller RBWu YADeyo RASinger DE: Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine 30:9369432005

4

Coe JDArlet VDonaldson WBerven SHanson DSMudiyam R: Complications in spinal fusion for adolescent idiopathic scoliosis in the new millennium. A report of the Scoliosis Research Society Morbidity and Mortality Committee. Spine 31:3453492006

5

Deyo RACherkin DCLoeser JDBigos SJCiol MA: Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure. J Bone Joint Surg Am 74:5365431992

6

Johnsson KERosén IUdén A: The natural course of lumbar spinal stenosis. Clin Orthop Relat Res 279:82861992

7

Katz JNLipson SJLarson MGMcInnes JMFossel AHLiang MH: The outcome of decompressive laminectomy for degenerative lumbar stenosis. J Bone Joint Surg Am 73:8098161991

8

Ragab AAFye MABohlman HH: Surgery of the lumbar spine for spinal stenosis in 118 patients 70 years of age or older. Spine 28:3483532003

9

Sanderson PLWood PL: Surgery for lumbar spinal stenosis in old people. J Bone Joint Surg Br 75:3933971993

10

Vitaz TWRaque GHShields CBGlassman SD: Surgical treatment of lumbar spinal stenosis in patients older than 75 years of age. J Neurosurg 91:2 Suppl1811851999

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 76 76 46
Full Text Views 28 28 7
PDF Downloads 41 41 8
EPUB Downloads 0 0 0

PubMed

Google Scholar