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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Is spinal surgery safe in octogenarians?

Harrison G Mihailidis1, Simon Manners2, Leonid Churilov3

  • 1The University of Melbourne Medical School, Austin Health, Melbourne, Victoria, Australia.

ANZ Journal of Surgery
|January 27, 2017
PubMed
Summary
This summary is machine-generated.

Spinal surgery in patients over 80 is feasible for well-selected individuals. However, the extent of surgery and high comorbidity scores (CCI, CIRS-G) correlate with increased complications in octogenarian patients.

Keywords:
aged (over 80)neurosurgeryoperativeorthopaedic surgerypostoperative complicationsspinalsurgical

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Area of Science:

  • Geriatric Medicine
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • The aging global population necessitates increased spinal surgeries in octogenarians.
  • Predicting surgical risks in elderly patients is crucial for safe patient selection.
  • Comorbidities and surgical extent impact outcomes in elderly spinal surgery patients.

Purpose of the Study:

  • To identify factors associated with complications in patients over 80 undergoing spinal surgery.
  • To evaluate the predictive value of comorbidity and physical status scales for surgical complications.
  • To determine if comorbidities and surgical extent correlate with adverse events in octogenarians.

Main Methods:

  • Retrospective cohort study analyzing 54 patients over 80 years old.
  • Comorbidities assessed using American Society of Anesthesiologists (ASA) rating, Charlson Comorbidity Index (CCI), and Cumulative Illness Rating Scale for Geriatrics (CIRS-G).
  • Negative binomial regression used to analyze the association between comorbidities, surgical extent, and complications.

Main Results:

  • 38 out of 54 patients experienced at least one complication, including six deaths.
  • Higher CIRS-G and CCI scores were linked to more complications in the elective surgery group.
  • Increased number of operated spinal levels correlated with a higher incidence of complications.

Conclusions:

  • Elective spinal surgery can be safe for carefully selected octogenarian patients.
  • Surgical extent, CIRS-G, and CCI scores are significant predictors of complications in elderly spinal surgery patients.
  • Risk stratification using comorbidity indices is essential for octogenarian spinal surgery candidates.