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Cervical Spine Surgery Complications and Risks in the Elderly.

Kris Radcliff1, Kevin L Ong2, Scott Lovald3

  • 1Rothman Institute, Egg Harbor Township, NJ.

Spine
|March 15, 2017
PubMed
Summary

Elderly patients undergoing cervical spine surgery (cervical decompression or cervical fusion) face risks of complications like respiratory issues and delirium. Older age and specific comorbidities increase these risks, informing future patient care strategies.

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Area of Science:

  • Neurosurgery and Orthopedic Surgery
  • Geriatric Medicine
  • Health Services Research

Background:

  • Cervical spine procedures have increased in the US, leading to higher hospital costs.
  • Postoperative complications significantly extend hospital stays and escalate healthcare expenses.
  • Understanding complication rates in elderly populations is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To evaluate the incidence of postoperative complications following cervical decompression (CD) and cervical fusion (CF).
  • To identify demographic and clinical risk factors associated with these complications in elderly Medicare beneficiaries.
  • To establish baseline complication data for elderly patients undergoing cervical spine surgery.

Main Methods:

  • Analysis of 5% Medicare Part B claims data from 2010-2012.

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  • Inclusion of 1519 CD and 1273 CF patients aged 65 and older.
  • Multivariate Cox regression used to assess risk factors (age, socioeconomic status, comorbidities, race, sex, etc.) for 90-day postoperative complications.

    • Main Results:

    • Most common complications included respiratory issues (12.1-14.6%), urinary retention (8.2-9.1%), acute delirium (5.3-6.0%), and nausea/vomiting (2.8-3.1%).
    • Older age was linked to higher risks of respiratory complications and delirium.
    • Male sex increased urinary retention risk; dementia elevated delirium risk; females had higher nausea/vomiting rates after CD and CF.

    Conclusions:

    • Identified specific risk factors for common complications in elderly cervical spine surgery patients.
    • Provides essential baseline data on complication rates for cervical decompression and fusion in this demographic.
    • Findings can guide strategies to mitigate postoperative complications and improve patient outcomes.