The influence of age on the peri- and postoperative clinical course in patients undergoing minimally invasive transforaminal lumbar interbody fusion techniques of the lumbar spine

Senker, Wolfgang; Stefanits, Harald; Gmeiner, Matthias; Trutschnig, Wolfgang; Radl, Christian; Gruber, Andreas

doi:10.1016/j.clineuro.2019.04.025

Cited by 3 publications

(7 citation statements)

References 22 publications

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“…Specifically, it was defined as non‐surgical complications as the result of medical conditions not directly related to surgery (Adogwa, Elsamadicy, Fialkoff, et al, 2017; Adogwa, Elsamadicy, Lydon, et al, 2017), and by following the International Classification of Diseases, Ninth revision (ICD ‐9 codes) (Baker et al, 2017; Drazin et al, 2017). Three studies used major and minor complications to categorise postoperative complication before discharge (Senker et al, 2019; Snopko et al, 2018; Zhan et al, 2019). As shown in Table 4, heterogeneous definitions for delirium ( n = 6) exist throughout the literature.…”

Section: Resultsmentioning

confidence: 99%

“…This second co‐occurrence network analysis explores the patterns and concept associations using major and minor classification of the complications. The authors synthesised prior research to guide their decision‐making assigning the study medical complications into major or minor (Carreon et al, 2003; Glassman et al, 2007; Jain et al, 2017; Klineberg et al, 2020; Machado et al, 2017; Senker et al, 2019; Snopko et al, 2018; Zhan et al, 2019). All complications classified as major are represented in blue, minor complications in pink.…”

Section: Resultsmentioning

confidence: 99%

“…Fatal pulmonary embolus (PE), transient ischaemic attack, pneumonia, atrial fibrillation, cardiac ischaemia or myocardial infarction (Senker et al, 2019).…”

Section: Major Complicationsmentioning

confidence: 99%

“…Sub-febrile temperature, fever, UTI, anaemia, enteritis, urinary retention, reflux esophagitis, pre-ileus, gout attack or neurologic deficits (Senker et al, 2019).…”

Section: Minor Complicationsmentioning

confidence: 99%

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In‐hospital medical complication in older people after spine surgery: A scoping review

Strayer

Kuo

King

2022

Int J Older People Nursing

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Objective Worldwide, older people are suffering from lumbar degenerative disease at an annual rate of 266 million. Although spine surgeries restore mobility, reduce pain and resolve neurological damage, these procedures can place older persons at high‐risk for medical complications due to multiple comorbid conditions that are often present in this population. However, the prevalence of complications occurring in older people prior to discharge is unknown. Postoperative medical complications lead to increased healthcare costs as well as pain and potential harm for the patient. Hence, this scoping review aimed to provide an overview of the current knowledge state regarding in‐hospital medical postoperative complications in older people (≥65 years) after elective spine surgery. Method A scoping review was conducted following Arksey and O’Malley's framework. Four databases (PubMed, Cochrane, Scopus and CINAHL) were systematically searched. Inclusion criteria were medical complication(s) after elective spine surgery prior to discharge, age ≥65 years and English language. Co‐occurrence analysis was used to examine how often each complication was examined in the literature and how often the complications co‐occur. Results Twenty‐six studies met inclusion criteria. The most frequently examined postoperative medical complications after spine surgery are delirium and urinary tract infection, followed by gastrointestinal and pulmonary embolus. Despite the list of in‐hospital medical complications, definitions or criteria for measurement of any identified complication were sparse and inconsistent. There is a lack of definition or instruments to comprehensively assess medical complications incurred by older people following spine surgery, including characteristics, classification methodology and temporality. To date, no research has been conducted on how older people experience or perceive a medical complication after elective spine surgery. Conclusion The findings highlight the importance to develop comprehensive instruments to assess co‐occurrence of postoperative medical complications and design interventions to mitigate the negative impacts of medical complications incurred by older people after spine surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Fatal pulmonary embolus (PE), transient ischaemic attack, pneumonia, atrial fibrillation, cardiac ischaemia or myocardial infarction (Senker et al, 2019).…”

Section: Major Complicationsmentioning

confidence: 99%

“…Sub-febrile temperature, fever, UTI, anaemia, enteritis, urinary retention, reflux esophagitis, pre-ileus, gout attack or neurologic deficits (Senker et al, 2019).…”

Section: Minor Complicationsmentioning

confidence: 99%

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In‐hospital medical complication in older people after spine surgery: A scoping review

Strayer

Kuo

King

2022

Int J Older People Nursing

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“…1). [20][21][22][23][24][25][26][27][28][29][30][31] Two studies performed prospective data collection and analysis, 21,29 whereas the remaining 10 performed retrospective analyses.…”

Section: Resultsmentioning

confidence: 99%

Outcomes and complications of minimally invasive transforaminal lumbar interbody fusion in the elderly: a systematic review and meta-analysis

Huang

Rabin

Stricsek

et al. 2022

Journal of Neurosurgery: Spine

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OBJECTIVE Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be used to treat degenerative spinal pathologies while reducing risks associated with open procedures. As an increasing number of lumbar fusions are performed in the aging United States population, MIS-TLIF has been widely adopted into clinical practice in recent years. However, its complication rate and functional outcomes in elderly patients remain poorly characterized. The objective of this study was to assess complication rates and functional outcomes in elderly patients (≥ 65 years old) undergoing MIS-TLIF. METHODS The PubMed, Embase, and Scopus databases were searched for relevant records in accordance with the PRISMA guidelines. Inclusion criteria were peer-reviewed original research; English language; full text available; use of MIS-TLIF; and an elderly cohort of at least 5 patients. Risk of bias was assessed using the ROBINS-I (Risk of Bias in Nonrandomized Studies—of Interventions) tool. Pooled complication rates were calculated for elderly patients, with subgroup analyses performed for single versus multiple-level fusions. Complication rates in elderly compared to nonelderly patients were also assessed. Postoperative changes in patient-reported outcomes, including Oswestry Disability Index (ODI) and visual analog scale (VAS) back pain (BP) and leg pain (LP) scores, were calculated. RESULTS Twelve studies were included in the final analysis. Compared to nonelderly patients, MIS-TLIF in elderly patients resulted in significantly higher rates of major (OR 2.15, 95% CI 1.07–4.34) and minor (OR 2.20, 95% CI 1.22–3.95) complications. The pooled major complication rate in elderly patients was 0.05 (95% CI 0.03–0.08) and the pooled minor complication rate was 0.20 (95% CI 0.13–0.30). Single-level MIS-TLIF had lower major and minor complication rates than multilevel MIS-TLIF, although not reaching significance. At a minimum follow-up of 6 months, the postoperative change in ODI (−30.70, 95% CI −41.84 to −19.55), VAS-BP (−3.87, 95% CI −4.97 to −2.77), and VAS-LP (−5.11, 95% CI −6.69 to −3.53) in elderly patients all exceeded the respective minimum clinically important difference. The pooled rate of fusion was 0.86 (95% CI 0.80–0.90). CONCLUSIONS MIS-TLIF in elderly patients results in a high rate of fusion and significant improvement of patient-reported outcomes, but has significantly higher complication rates than in nonelderly patients. Limitations of this study include heterogeneity in the definition of elderly and limited reporting of risk factors among included studies. Further study of the impact of complications and the factors predisposing elderly patients to poor outcomes is needed.

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Myocardial Infarction After Lumbar Surgery: A Critical Meta-Analysis of Cohort versus Database Studies for a Rare Complication

Perez-Roman¹,

Lu²,

Govindarajan³

et al. 2022

World Neurosurgery

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The influence of age on the peri- and postoperative clinical course in patients undergoing minimally invasive transforaminal lumbar interbody fusion techniques of the lumbar spine

Cited by 3 publications

References 22 publications

In‐hospital medical complication in older people after spine surgery: A scoping review

In‐hospital medical complication in older people after spine surgery: A scoping review

Outcomes and complications of minimally invasive transforaminal lumbar interbody fusion in the elderly: a systematic review and meta-analysis

Myocardial Infarction After Lumbar Surgery: A Critical Meta-Analysis of Cohort versus Database Studies for a Rare Complication

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