The Safety of Spine Surgery in the Late-Stage Elderly of 75 Years of Age or Older: A Retrospective Multicenter Study

Sakai, Kosuke; Ikeda, Naokado; Fukumura, Masao; Omura, Naoki; Yagi, Ryokichi; Hiramatsu, Rikako; Kameda, Masahiro; Nonoguchi, Naosuke; Furuse, Motomasa; Kawabata, Shinji; Kajimoto, Yoshinaga; Miyatake, Shin‐Ichi; Yokoyama, Kunio; Kawanishi, Masahiro; Fujishiro, Takahiro; Tanabe, Hideki; Wanibuchi, Masahiko; Takami, Toshihiro

doi:10.1016/j.wneu.2023.01.072

Cited by 1 publication

(1 citation statement)

References 21 publications

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“…Preoperative physical condition was estimated in accordance with the American Society of Anesthesiologists Physical Status (ASA-PS) classification system. 6 , 7 ) Preoperative data regarding patient ability to perform the activities of daily living were estimated using a 5-grade scale based on the Eastern Cooperative Oncology Group Performance Status (ECOG-PS), a widely accepted measure to quantify the physical condition of patients. 7 , 8 ) This scale ranges from Grade 0 (fully active, able to carry on all pre-disease performance without restriction) to Grade 1 (restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature), Grade 2 (ambulatory and capable of all self-care but unable to carry out any work activities; up and approximately more than 50% of waking hours), Grade 3 (capable of only limited self-care; confined to bed or chair more than 50% of waking hours), and Grade 4 (completely disabled; cannot carry on any self-care; totally confined to bed or chair).…”

Section: Methodsmentioning

confidence: 99%

Postoperative Airway Management after Anterior Cervical Spine Surgery: Retrospective Neurosurgical Multicenter Study

FUJIKAWA,

IKEDA,

SAKAI

et al. 2024

Neurol. Med. Chir.(Tokyo)

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Airway complications that occur after anterior cervical spine surgery pose a life-threatening risk, which encompasses complications including prolonged intubation, unplanned reintubation, and/or necessity of tracheostomy. The present study aimed to identify the surgical risks associated with postoperative airway complications in neurosurgical training institutes. A retrospective, multicenter, observational review of data from 365 patients, who underwent anterior cervical spine surgery between 2018 and 2022, at three such institutes was carried out. Postoperative airway complication was defined as either the need for prolonged intubation on the day of surgery or the need for unplanned reintubation. The perioperative medical information was obtained from their medical records. The average age of the cohort was over 60 years, with males comprising approximately 70%. Almost all surgeries predominantly involved anterior cervical discectomy and fusion or anterior cervical corpectomy and fusion, with most surgeries occurring at the level of C5/6. In total, 363 of 365 patients (99.5%) were extubated immediately after surgery, and the remaining two patients were kept under intubation because of the risk of airway complications. Of the 363 patients who underwent extubation immediately after surgery, two (0.55%) required reintubation because of postoperative airway complications. Patients who experienced airway complications were notably older and exhibited a significantly lower body mass index. The results of this study suggested that older and frailer individuals are at an elevated risk for postoperative airway complications, with immediate postoperative extubation generally being safe but requiring careful judgment in specific cases.

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