title: Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis.
abstract: OBJECTIVE
  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 >or= 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.
authors.affiliation: Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
authors.forename: Kai-Ming G
authors.initials: KM
authors.lastname: Fu
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.forename: David W
authors.initials: DW
authors.lastname: Polly
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Perra
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sansur
authors.forename: Sigurd H
authors.initials: SH
authors.lastname: Berven
authors.forename: Paul A
authors.initials: PA
authors.lastname: Broadstone
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Choma
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goytan
authors.forename: Hilali H
authors.initials: HH
authors.lastname: Noordeen
authors.forename: D Raymond
authors.initials: DR
authors.lastname: Knapp
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hart
authors.forename: Reinhard D
authors.initials: RD
authors.lastname: Zeller
authors.forename: William F
authors.initials: WF
authors.lastname: Donaldson
authors.forename: Oheneba
authors.initials: O
authors.lastname: Boachie-Adjei
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D006801:Humans; D008159:Lumbar Vertebrae; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011446:Prospective Studies; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000601:surgery*