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:
“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;
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;
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!
Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong
Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...
An interdisciplinary group of researchers interfaced individual bacteria with a computer to build a hybrid bio-digital circuit - Study published in Nature Communications
Scientists at the Institute of Science and Technology Austria (IST Austria) have managed to control the behavior of individual bacteria by connecting them to a...
Physicists in the Laboratory for Attosecond Physics (run jointly by LMU Munich and the Max Planck Institute for Quantum Optics) have developed an attosecond electron microscope that allows them to visualize the dispersion of light in time and space, and observe the motions of electrons in atoms.
The most basic of all physical interactions in nature is that between light and matter. This interaction takes place in attosecond times (i.e. billionths of a...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
11.12.2017 | Physics and Astronomy
11.12.2017 | Earth Sciences
11.12.2017 | Information Technology