Effects of age and co-morbidities on complication rate in surgical treatment of lumbar degenerative diseases: a prospective clinical study

INTRODUCTION: Surgery for lumbar degenerative diseases is increasingly more common due to ageing of the population. There were conflicting results on effects of complication rates of ageing and presence of comorbidities in these operations in literature.

METHODS: Presence of systemic co-morbidities, smoking, body mass index (BMI), American Society of Anaesthesiologists score, length of hospital before and after operation and in intensive care unit (ICU), number of decompressed levels (nD), addition of instrumentation, operation time, blood loss, presence of transfusion, surgical and systemic complications seen during the operation and during one month after operation, and requirement of a new operation were recorded in 277 patients (61.6±8.8 years of age, male/female ratio 78/199) operated for lumbar degenerative diseases between 2014 and 2016.
RESULTS: Total 96 out of 277 patients (34.6%) had complications and 1 patient died. The most frequent complications were dural tear (36 cases, 12.9%), wound problems without infection (34 cases, 12.2%), screw malposition (15 cases, 5.4%), and systemic complications (21 cases, 7.5%).
The risk factors were diabetes mellitus (DM) for major complications, BMI and nD for minor complications, and nD for systemic complications. All other factors including age did not affect the complication rate. Regression analyses revealed that the only efficient factor was BMI for presence of overall and minor complications.

DISCUSSION AND CONCLUSION: It was found that the advanced age did not cause to increase complication rates. The efficient factors for complication rates were DM, BMI and nD.