- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Surgical Interventions
Spine Surgery Statistics
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Spine Surgery Statistics
Sobottke R, CsÈcsei G, Kaulhausen T, Delank S, Franklin J, Aghayev E, Zweig T, Eysel P. Spinal surgery in the elderly: does age have an influence on the complication rate?] Orthopade. 2008 Apr;37(4):367-73.
However, a review of the existing literature, the results of the European spine register "Spine Tango" and our own results show that the rate of complications after minimally invasive spinal surgery is as low in the elderly as it is in the younger population. But the higher the complexity of surgery, the higher the rate of complications with increasing age. However, even elderly (>65 years) and very elderly (>80 years) patients seem to benefit from surgical treatment, independent of the extent of spinal surgery. Because chronic pain leads to physical limitations, an impaired quality of life as well as a declined state of health, and because surgery can significantly improve these factors, even while remaining aware of the operational risks, age itself should not be considered as a contraindication for spinal surgery.
Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, Fraser VJ. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am. 2008 Jan;90(1):62-9
Surgical site infections are not uncommon following spinal operations, and they can be associated with serious morbidity, mortality, and increased resource utilization. Diabetes was associated with the highest independent risk of spinal surgical site infection, and an elevated preoperative or postoperative serum glucose level was also independently associated with an increased risk of surgical site infection. The role of hyperglycemia as a risk factor for surgical site infection in patients not previously diagnosed with diabetes should be investigated further. Administration of prophylactic antibiotics within one hour before the operation and increasing the antibiotic dosage to adjust for obesity are also important strategies to decrease the risk of surgical site infection after spinal operations.
Browne JA, Cook C, Pietrobon R, Bethel MA, Richardson WJ. Diabetes and early postoperative outcomes following lumbar fusion. Spine. 2007 Sep 15;32(20):2214-9
Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. The primary objective was to examine perioperative morbidity and mortality for patients with and without diabetes mellitus following lumbar spinal fusion. This nationally representative study of inpatients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications, nonroutine discharge, increased total hospital charges, and length of stay following lumbar fusion. Prospective studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done.
Cook C, Tackett S, Shah A, Pietrobon R, Browne J, Viens N, Richardson W, Isaacs R. Diabetes and perioperative outcomes following cervical fusion in patients with myelopathy. Spine. 2008 Apr 15;33(8):E254-60.
Database study using the Nationwide Inpatient Sample administrative data from 1988 through 2004. The primary objective was to examine perioperative morbidity and mortality for patients diagnosed with myelopathy, with and without diabetes mellitus (DM) (and subclassifications) following cervical spinal fusion. DM has been associated with worse outcomes in a variety of orthopedic procedures including spinal surgery. Evidence that patients with DM have more complications following cervical fusion, specifically those treated for myelopathy, has been suggested within the literature but has been poorly explored. Data from 37,732 patients within Nationwide Inpatient Sample database (1988-2004) with diagnostic codes specifying the presence of myelopathy and who underwent cervical fusion were included in the analysis. This nationally representative study of inpatients in the United States provides evidence that patients with DM who received cervical fusion secondary to myelopathy are associated with greater perioperative complications, nonroutine discharge, and increased total charges. Subanalyses suggest that uncontrolled DM is a significant associative factor in outcome.
However, a review of the existing literature, the results of the European spine register "Spine Tango" and our own results show that the rate of complications after minimally invasive spinal surgery is as low in the elderly as it is in the younger population. But the higher the complexity of surgery, the higher the rate of complications with increasing age. However, even elderly (>65 years) and very elderly (>80 years) patients seem to benefit from surgical treatment, independent of the extent of spinal surgery. Because chronic pain leads to physical limitations, an impaired quality of life as well as a declined state of health, and because surgery can significantly improve these factors, even while remaining aware of the operational risks, age itself should not be considered as a contraindication for spinal surgery.
Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, Fraser VJ. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am. 2008 Jan;90(1):62-9
Surgical site infections are not uncommon following spinal operations, and they can be associated with serious morbidity, mortality, and increased resource utilization. Diabetes was associated with the highest independent risk of spinal surgical site infection, and an elevated preoperative or postoperative serum glucose level was also independently associated with an increased risk of surgical site infection. The role of hyperglycemia as a risk factor for surgical site infection in patients not previously diagnosed with diabetes should be investigated further. Administration of prophylactic antibiotics within one hour before the operation and increasing the antibiotic dosage to adjust for obesity are also important strategies to decrease the risk of surgical site infection after spinal operations.
Browne JA, Cook C, Pietrobon R, Bethel MA, Richardson WJ. Diabetes and early postoperative outcomes following lumbar fusion. Spine. 2007 Sep 15;32(20):2214-9
Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. The primary objective was to examine perioperative morbidity and mortality for patients with and without diabetes mellitus following lumbar spinal fusion. This nationally representative study of inpatients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications, nonroutine discharge, increased total hospital charges, and length of stay following lumbar fusion. Prospective studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done.
Cook C, Tackett S, Shah A, Pietrobon R, Browne J, Viens N, Richardson W, Isaacs R. Diabetes and perioperative outcomes following cervical fusion in patients with myelopathy. Spine. 2008 Apr 15;33(8):E254-60.
Database study using the Nationwide Inpatient Sample administrative data from 1988 through 2004. The primary objective was to examine perioperative morbidity and mortality for patients diagnosed with myelopathy, with and without diabetes mellitus (DM) (and subclassifications) following cervical spinal fusion. DM has been associated with worse outcomes in a variety of orthopedic procedures including spinal surgery. Evidence that patients with DM have more complications following cervical fusion, specifically those treated for myelopathy, has been suggested within the literature but has been poorly explored. Data from 37,732 patients within Nationwide Inpatient Sample database (1988-2004) with diagnostic codes specifying the presence of myelopathy and who underwent cervical fusion were included in the analysis. This nationally representative study of inpatients in the United States provides evidence that patients with DM who received cervical fusion secondary to myelopathy are associated with greater perioperative complications, nonroutine discharge, and increased total charges. Subanalyses suggest that uncontrolled DM is a significant associative factor in outcome.
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