Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study Identifies Risk Factors for Complications after Spine Surgery

21.09.2011
Findings aim to help patients and surgeons address potential risks before surgical procedures

In the last 20 years, due to diagnostic and surgical advances, more and more patients have become appropriate candidates for spine surgery, and the number of these procedures performed has risen significantly. While medical experts acknowledge the potential benefits of spine surgery, they also understand that complications can reduce the success in the short and long term.

“Complications following spine surgery may have a substantial impact on the quality of life of patients as well as the outcome of the primary surgical procedure,” said orthopaedic surgeon Andrew J. Schoenfeld, MD, one of the authors of a new study recently published in the Journal of Bone and Joint Surgery (JBJS). This study identified several risk factors for a variety of complications and death shortly after spine surgery among men and women across the U.S.

Relatively few studies have explored the impact of factors such as comorbid medical conditions (simultaneously and usually independently existing health problems, including diabetes and cardiovascular conditions), age, body mass index (BMI), and gender on the risk of complications following spine surgery. Most research to date has focused exclusively on wound infection, and few studies have explored other possible complications and death.

“At the present time, the results of this study may represent some of the best available evidence regarding risk factors for complications and mortality following spine surgery,” said Dr. Schoenfeld.

Study Details:
The study authors evaluated the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database for the years 2005 to 2008. This database documents preoperative information and postoperative complications and death among patients receiving surgery at participating medical facilities across the United States.

“One of the principle advantages of the NSQIP dataset is that it encompasses patients in selected hospitals from across the United States and includes a variety of spine surgical procedures,” said Dr. Schoenfeld.

The study authors identified patients who received one or more spine operations.

From 2005 to 2008, 3,475 spine-surgery patients were registered in the database.

They ranged in age from 16 to 90, and the average age was 55.5.

Fifty-four percent of the patients were men, and 76 percent were Caucasian.

These patients underwent back surgery for conditions such as:

Disc herniation (ruptured or slipped discs, the rubbery cushions between vertebrae);

Spinal stenosis (narrowing of the spinal canal); and

Degenerative disc disease (the progressive deterioration of discs).

Researchers then collected a wide range of demographic information and complications and death that occurred within 30 days after surgery for all the patients. Major complications included deep vein thrombosis (blood clots deep in the legs), sepsis (a life-threatening condition caused by a bacterial infection), deep wound infections, and unplanned return to the operating room. Minor complications included urinary tract infections, pneumonia, and superficial wound infections.

The death rate was .03 percent, (10 out of 3475 patients), while 7.6 percent (263 out of 3475 patients) experienced complications within 30 days after surgery. The preoperative and postoperative data indicated that increasing patient age and surgical wound problems independently increased the risk of death. The data also identified the following independent risk factors for developing one or more complications within this 30-day period:

Older patient age;
Congestive heart failure and/or a history of heart attack;
Preoperative neurological problems;
A history of spinal wound infection;
Use of corticosteroids;
A history of sepsis;
A classification of 3 or higher according to the American Society of Anesthesiologists physical status classification system (a system that evaluates a patient’s health status prior to surgery); and

Prolonged surgery times.

People who already have had spine surgery and those considering it should keep the results of this national study in perspective, said Dr. Schoenfeld.

“Our study only documents complications and mortality that occurred within 30 days after surgery. Many studies exist that illustrate the safety and efficacy of spine surgery, and the intent of this work was not to be alarmist. Our goal was to identify medical conditions and other factors that could be addressed prior to surgery in order to further enhance the safety of spine surgery and help achieve the best results for patients. We hope that our findings will allow surgeons, patients, and their families to have a more open dialogue and discussion regarding potential risks prior to surgery.”

The American Academy of Orthopaedic Surgeons (AAOS) suggests that patients considering spinal surgery:

Tell their doctor about any and all infections, no matter how distant or unrelated they might seem;
Schedule an appointment with your primary care provider to be sure your overall health is optimized;
Stop smoking; and
If need be, consider postponing surgery to undertake a fitness or weight control program.

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the 36 months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work.

Disclaimer: Some authors of this study are employees of the U.S. federal government and the United States Army. The opinions or assertions contained in the study are the private views of the authors and are not to be construed as official or reflecting the views of the William Beaumont Army Medical Center, the Department of Defense, or the United States government.

The AAOS has more information on spine surgery, which can be found at www.orthoinfo.org

Lauren Pearson | EurekAlert!
Further information:
http://www.aaos.org

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Transport of molecular motors into cilia

28.03.2017 | Life Sciences

A novel hybrid UAV that may change the way people operate drones

28.03.2017 | Information Technology

NASA spacecraft investigate clues in radiation belts

28.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>