Tremor Impacts Posterior Lumbar Interbody Fusion Outcomes.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Clinical Outcomes Research

Background:

• Spine surgery in Parkinson disease (PD) patients is associated with high complication rates.
• Limited research exists on outcomes for other movement disorders, including tremor, after spine surgery.

Purpose of the Study:

• To investigate the outcomes of posterior lumbar fusion in patients with comorbid tremor diagnoses.
• To compare complication rates and opioid use between tremor and non-tremor patients undergoing lumbar fusion.

Main Methods:

• Retrospective analysis of adult patients undergoing posterior lumbar fusion (2016-2019) using the PearlDiver Claims Database.
• Extracted data included patient demographics, short-term (≤90 days) and long-term (>365 days) opioid use, and various surgical outcomes.
• Univariate analysis and propensity score matching were employed to compare tremor and non-tremor patient groups.

Main Results:

• The study included 54,231 non-tremor, 1265 PD, and 2828 tremor patients.
• Tremor patients exhibited higher Charlson Comorbidity Index, long-term opioid use, medical complications (5.0%), ER visits (30.5%), 90-day readmissions (7.7%), and revision surgery (5.8%).
• Post-propensity score matching, tremor patients still showed significantly higher rates of medical complications, revision surgery, 90-day readmissions, and ER visits compared to non-tremor patients.

Conclusions:

• Tremor patients may face increased complications and long-term opioid use following lumbar fusion compared to those without movement disorders.
• This study highlights tremor as a significant comorbidity affecting multiple spine surgery outcomes, challenging its perception as benign.
• Findings underscore the need for careful preoperative assessment and management of tremor patients undergoing spinal fusion.