Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis

Kai Ming G Fu, Justin S. Smith, David W. Polly, Joseph H. Perra, Charles A. Sansur, Sigurd H. Berven, Paul A. Broadstone, Theodore J. Choma, Michael J. Goytan, Hilali H. Noordeen, D. Raymond Knapp, Robert Hart, Reinhard D. Zeller, William F. Donaldson, Oheneba Boachie-Adjei, Christopher I. Shaffrey

Research output: Contribution to journalArticle

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Abstract

Object. The purpose of this study was to evaluate the prospectively collected Scoliosis Research Society (SRS) database to assess the incidences of morbidity and mortality (M&M) in the operative treatment of degenerative lumbar stenosis, one of the most common procedures performed by spine surgeons. Methods. All patients who underwent surgical treatment for degenerative lumbar stenosis between 2004 and 2007 were identified from the SRS M&M database. Inclusion criteria for analysis included an age ≥ 21 years and no history of lumbar surgery. Patients were treated with either decompression alone or decompression with concomitant fusion. Statistical comparisons were performed using a 2-sided Fisher exact test. Results. Of the 10,329 patients who met the inclusion criteria, 6609 (64%) were treated with decompression alone, and 3720 (36%) were treated with decompression and fusion. Among those who underwent fusion, instrumentation was placed in 3377 (91%). The overall mean patient age was 63 ± 13 years (range 21-96 years). Seven hundred nineteen complications (7.0%), including 13 deaths (0.1%), were identified. New neurological deficits were reported in 0.6% of patients. Deaths were related to cardiac (4 cases), respiratory (5 cases), pulmonary embolus (2 cases), and sepsis (1 case) etiologies, and a perforated gastric ulcer (1 case). Complication rates did not differ based on patient age or whether fusion was performed. Minimally invasive procedures were associated with fewer complications and fewer new neurological deficits (p = 0.01 and 0.03, respectively). Conclusions. The results from this analysis of the SRS M&M database provide surgeons with useful information for preoperative counseling of patients contemplating surgical intervention for symptomatic degenerative lumbar stenosis.

Original languageEnglish (US)
Pages (from-to)443-446
Number of pages4
JournalJournal of Neurosurgery: Spine
Volume12
Issue number5
DOIs
StatePublished - May 2010

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Pathologic Constriction
Morbidity
Decompression
Mortality
Scoliosis
Databases
Therapeutics
Research
Stomach Ulcer
Embolism
Counseling
Sepsis
Spine
Lung
Incidence
Surgeons

Keywords

  • Adult
  • Complication
  • Lumbar stenosis
  • Scoliosis research society
  • Spine surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Fu, K. M. G., Smith, J. S., Polly, D. W., Perra, J. H., Sansur, C. A., Berven, S. H., ... Shaffrey, C. I. (2010). Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis. Journal of Neurosurgery: Spine, 12(5), 443-446. https://doi.org/10.3171/2009.11.SPINE09531

Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis. / Fu, Kai Ming G; Smith, Justin S.; Polly, David W.; Perra, Joseph H.; Sansur, Charles A.; Berven, Sigurd H.; Broadstone, Paul A.; Choma, Theodore J.; Goytan, Michael J.; Noordeen, Hilali H.; Knapp, D. Raymond; Hart, Robert; Zeller, Reinhard D.; Donaldson, William F.; Boachie-Adjei, Oheneba; Shaffrey, Christopher I.

In: Journal of Neurosurgery: Spine, Vol. 12, No. 5, 05.2010, p. 443-446.

Research output: Contribution to journalArticle

Fu, KMG, Smith, JS, Polly, DW, Perra, JH, Sansur, CA, Berven, SH, Broadstone, PA, Choma, TJ, Goytan, MJ, Noordeen, HH, Knapp, DR, Hart, R, Zeller, RD, Donaldson, WF, Boachie-Adjei, O & Shaffrey, CI 2010, 'Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis', Journal of Neurosurgery: Spine, vol. 12, no. 5, pp. 443-446. https://doi.org/10.3171/2009.11.SPINE09531
Fu, Kai Ming G ; Smith, Justin S. ; Polly, David W. ; Perra, Joseph H. ; Sansur, Charles A. ; Berven, Sigurd H. ; Broadstone, Paul A. ; Choma, Theodore J. ; Goytan, Michael J. ; Noordeen, Hilali H. ; Knapp, D. Raymond ; Hart, Robert ; Zeller, Reinhard D. ; Donaldson, William F. ; Boachie-Adjei, Oheneba ; Shaffrey, Christopher I. / Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis. In: Journal of Neurosurgery: Spine. 2010 ; Vol. 12, No. 5. pp. 443-446.
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abstract = "Object. The purpose of this study was to evaluate the prospectively collected Scoliosis Research Society (SRS) database to assess the incidences of morbidity and mortality (M&M) in the operative treatment of degenerative lumbar stenosis, one of the most common procedures performed by spine surgeons. Methods. All patients who underwent surgical treatment for degenerative lumbar stenosis between 2004 and 2007 were identified from the SRS M&M database. Inclusion criteria for analysis included an age ≥ 21 years and no history of lumbar surgery. Patients were treated with either decompression alone or decompression with concomitant fusion. Statistical comparisons were performed using a 2-sided Fisher exact test. Results. Of the 10,329 patients who met the inclusion criteria, 6609 (64{\%}) were treated with decompression alone, and 3720 (36{\%}) were treated with decompression and fusion. Among those who underwent fusion, instrumentation was placed in 3377 (91{\%}). The overall mean patient age was 63 ± 13 years (range 21-96 years). Seven hundred nineteen complications (7.0{\%}), including 13 deaths (0.1{\%}), were identified. New neurological deficits were reported in 0.6{\%} of patients. Deaths were related to cardiac (4 cases), respiratory (5 cases), pulmonary embolus (2 cases), and sepsis (1 case) etiologies, and a perforated gastric ulcer (1 case). Complication rates did not differ based on patient age or whether fusion was performed. Minimally invasive procedures were associated with fewer complications and fewer new neurological deficits (p = 0.01 and 0.03, respectively). Conclusions. The results from this analysis of the SRS M&M database provide surgeons with useful information for preoperative counseling of patients contemplating surgical intervention for symptomatic degenerative lumbar stenosis.",
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AU - Fu, Kai Ming G

AU - Smith, Justin S.

AU - Polly, David W.

AU - Perra, Joseph H.

AU - Sansur, Charles A.

AU - Berven, Sigurd H.

AU - Broadstone, Paul A.

AU - Choma, Theodore J.

AU - Goytan, Michael J.

AU - Noordeen, Hilali H.

AU - Knapp, D. Raymond

AU - Hart, Robert

AU - Zeller, Reinhard D.

AU - Donaldson, William F.

AU - Boachie-Adjei, Oheneba

AU - Shaffrey, Christopher I.

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N2 - Object. The purpose of this study was to evaluate the prospectively collected Scoliosis Research Society (SRS) database to assess the incidences of morbidity and mortality (M&M) in the operative treatment of degenerative lumbar stenosis, one of the most common procedures performed by spine surgeons. Methods. All patients who underwent surgical treatment for degenerative lumbar stenosis between 2004 and 2007 were identified from the SRS M&M database. Inclusion criteria for analysis included an age ≥ 21 years and no history of lumbar surgery. Patients were treated with either decompression alone or decompression with concomitant fusion. Statistical comparisons were performed using a 2-sided Fisher exact test. Results. Of the 10,329 patients who met the inclusion criteria, 6609 (64%) were treated with decompression alone, and 3720 (36%) were treated with decompression and fusion. Among those who underwent fusion, instrumentation was placed in 3377 (91%). The overall mean patient age was 63 ± 13 years (range 21-96 years). Seven hundred nineteen complications (7.0%), including 13 deaths (0.1%), were identified. New neurological deficits were reported in 0.6% of patients. Deaths were related to cardiac (4 cases), respiratory (5 cases), pulmonary embolus (2 cases), and sepsis (1 case) etiologies, and a perforated gastric ulcer (1 case). Complication rates did not differ based on patient age or whether fusion was performed. Minimally invasive procedures were associated with fewer complications and fewer new neurological deficits (p = 0.01 and 0.03, respectively). Conclusions. The results from this analysis of the SRS M&M database provide surgeons with useful information for preoperative counseling of patients contemplating surgical intervention for symptomatic degenerative lumbar stenosis.

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