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Perioperative Complications of Open Spine Surgery in Older Adults over 90 Years of Age

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Title: Perioperative Complications of Open Spine Surgery in Older Adults over 90 Years of Age
Authors: Tsujimoto, Takeru Browse this author
Kanayama, Masahiro Browse this author
Suda, Kota Browse this author
Oha, Fumihiro Browse this author
Komatsu, Miki Browse this author
Shimamura, Yukitoshi Browse this author
Tanaka, Masaru Browse this author
Ukeba, Daisuke Browse this author
Hasegawa, Yuichi Browse this author
Hashimoto, Tomoyuki Browse this author
Takahata, Masahiko Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Keywords: older adults
spine surgery
perioperative complication
Issue Date: 27-Nov-2022
Publisher: Japanese Society for Spine Surgery & Related Research
Journal Title: Spine Surgery and Related Research
Volume: 6
Issue: 6
Start Page: 664
End Page: 670
Publisher DOI: 10.22603/ssrr.2022-0036
Abstract: Introduction: Despite perioperative risks in nonagenarian patients who undergo open spine surgery for degeneration dis-order or spinal trauma being of great interest, the prevalence of complications in this group remains unclear. This study aims to examine the perioperative complications of open spine surgery in the elderly over 90 years of age.Methods: Preoperative and intraoperative characteristics including the American Society of Anesthesiologists Physical Status (ASA-PS) class, type of surgery, and complications within 30 postoperative days were retrospectively collected from the medical records of nonagenarians who underwent open spine surgery between April 2004 and July 2019 at our spine centers.Results: A total of 48 patients met the inclusion criteria of this study. All belong to ASA-PS class 2 (69%) or 3. Preop-erative American Spinal Injury Association Impairment Scale grades in trauma group were grade A in 4 cases, B in 1 case, C in 5 cases, D in 11 cases, and E in 1 case. Major complications (deep surgical site infection, cardiac event, respiratory disorder, gastrointestinal hemorrhage, and renal failure) occurred in 13 cases, and the rate of overall perioperative complica-tions was 45.8%. One patient who underwent cervical stabilization for cervical fracture dislocation died at postoperative 13 days due to respiratory disorder. The rates of major complications and overall perioperative complications were 3.6% and 14.3% in the degenerative group and 45.5% and 81.8% in the trauma group, respectively. Especially in the trauma group, respiratory disorder occurred in 7 cases, delirium in 11 cases, and urinary tract infection in 5 cases.Conclusions: Although the perioperative complication rate reached 81.8% in spinal trauma cases, the complication rate in degenerative disorders was relatively low as 14.3%. Open spine surgery for degenerative disorders can be relatively safe even in nonagenarians, whereas the risks of perioperative complications, including respiratory disorder and delirium, were high in spinal trauma cases.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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