Safety Evaluation of Cervical Dorsal Instrumentation in Geriatric Patients: Experience at a Level 1 Center for Spinal Surgery—A Single Center Cohort Study

Frontiers in Medicine

article

Ehab Shabo¹  Simon Brandecker¹  Shaleen Rana¹  Gregor Bara¹  Jasmin E. Scorzin¹  Lars Eichhorn²  Hartmut Vatter¹  Mohammed Banat¹ 

[1] Department of Neurosurgery, University Hospital Bonn;Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn

关键词: cervical dorsal instrumentation;    geriatric patients;    complication rate;    comorbidities;    CCI and CDG scores;   

DOI  :  10.3389/fmed.2022.824047

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Dorsal instrumentation of the cervical spine is an established treatment in spine surgery. However, careful planning is required, particularly in elderly patients. This study evaluates early clinical outcomes in geriatric patients undergoing complex spine surgery. Methods In this retrospective, single center cohort study, we included all geriatric patients (aged ≥65 years) who underwent dorsal instrumentation between January 2013 and December 2020. We analyzed postoperative complications and the 30-day in-hospital mortality rate. Furthermore, the Charlson comorbidity index (CCI) and Clavien-Dindo grading system (CDG) were used to assess the patients' comorbidity burden. Results In total, 153 patients were identified and included. The mean age of patients was 78 years ( SD ± 7). Traumatic injury (53.6%) was the most common reason for surgery. 60.8% of the patients underwent dorsal instrumentation with 3 or more levels. The most common comorbidities were arterial hypertension (64%), diabetes mellitus (22.2%), coronary heart disease and atrial fibrillation (19.6%). The most common adverse event (AE) was pneumonia (4%) and the most common surgery-related complication was wound infection (5.2%). Among patients categorized as high risk for AE (CCI > 5), 14.6% suffered a postoperative AE. In our univariate analysis, we found no risk factors for high rates of complications or mortality. Conclusion Our data demonstrates that older patients were at no significant risk of postoperative complications. The CCI/CDG scores may identify patients at higher risk for adverse events after dorsal instrumentation, and these assessments should become an essential component of stratification in this older patient population.

【 授权许可】

CC BY