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Constipation after thoraco-lumbar fusion surgery.
Martin N Stienen1, Nicolas R Smoll2, Gerhard Hildebrandt1
1Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Clinical Neurology and Neurosurgery
|September 26, 2014
Summary
Postoperative constipation is common after thoraco-lumbar fusion surgery. This condition is linked to longer operations, increased blood loss, and higher morphine use, impacting patient recovery.
Area of Science:
- Spinal Surgery
- Gastroenterology
- Anesthesiology
Background:
- Thoraco-lumbar posterior fusion is a common surgery for spinal instability.
- Patients often experience gastrointestinal issues like constipation and ileus post-surgery.
- Immobilization and opioid use contribute to these perioperative complications.
Purpose of the Study:
- To investigate the incidence of postoperative constipation after thoraco-lumbar fusion.
- To identify factors associated with the development of constipation in these patients.
Main Methods:
- Retrospective single-center study of patients undergoing thoraco-lumbar fusion for degenerative disease in 2012.
- Patients were grouped based on the presence or absence of postoperative constipation (no bowel movement on POD 0-2).
Main Results:
- Constipation occurred in 44.4% of 99 analyzed patients.
- Constipation was associated with longer operative times (247 vs. 214 min) and greater blood loss (545 vs. 375 ml).
- Higher postoperative morphine dosages were observed in constipated patients on POD 1 and 2.
Conclusions:
- Constipation is a frequent complication following thoraco-lumbar fusion.
- Longer surgery duration, increased blood loss, and elevated postoperative morphine requirements are linked to constipation.
- Further research into minimally invasive techniques may reduce these complications.
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