Impact of Elderly Age on Complications and Clinical Outcomes following Anterior Lumbar Interbody Fusion Surgery.

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Impact of Elderly Age on Complications and Clinical Outcomes following Anterior Lumbar Interbody Fusion Surgery.

World Neurosurg. 2017 May 19;:

Authors: Phan K, Ramachandran V, Tran T, Phan S, Rao PJ, Mobbs RJ

Abstract
BACKGROUND: Anterior Lumbar Interbody Fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients.
METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon. Patients were separated into age-based cohorts (≤49, 50-63, and ≥64 years of age). Chi-squared, Fisher's exact test, and multivariate logistic regression models were used to identify independent risk factors.
RESULTS: A total of 137 patients met the inclusion criteria. Patients were divided into age-based tertiles as following: Group 1 (<49 years old, n=45, 32.8%), Group 2 (50-63 years old, n=46, 33.6%), and Group 3 (64 years old, n=46, 33.6%). Univariate analysis revealed increasing age (relative to Group 1) to be an independent risk factor for postoperative hematoma, and delayed subsidence at 6 weeks and 12 weeks post-operatively compared to immediately post-operation (all p<0.05). No significant differences were found among the groups in terms of clinical outcome. Multivariate analysis also demonstrated increased age to be independently associated with greater prevalence of delayed subsidence (OR 9.174, p=0.029).
CONCLUSIONS: Increased age was not associated with adverse perioperative outcomes and complications of ALIF. However, there was an increased incidence of delayed subsidence in patients ≥64 years old.

PMID: 28532910 [PubMed - as supplied by publisher]

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