title: Postoperative Complications for Elderly Patients After Single-Level Lumbar Fusions for Spondylolisthesis.
abstract: OBJECTIVE
  A large-scale study on postoperative complications of lumbar fusion surgery for spondylolisthesis comparing patients >80 years old with younger patients has not been performed. The purpose of this study is to assess the effects of extreme age (>80 years old) on early postoperative outcomes after single-level lumbar fusions for spondylolisthesis.
  
  
  METHODS
  From a validated multicenter surgical database, 2475 patients who underwent a single-level lumbar fusion procedure for spondylolisthesis were selected retrospectively. An extreme age cohort with 227 patients >80 years old was compared with a typical age cohort with 2248 patients 45-65 years old.
  
  
  RESULTS
  The preoperative characteristics and comorbidities were different between the typical age cohort and the extreme age cohort, with older patients having more preoperative comorbidities, including a lack of independent functional health status before surgery (P < 0.001), severe chronic obstructive pulmonary disease (P <0.020), and hypertension requiring medication (P < 0.001). There was significantly greater morbidity among the >80 cohort regarding urinary tract infection (P = 0.008; odds ratio = 3.30; 95% confidence interval, 1.47-7.40) and intraoperative and postoperative transfusions (P < 0.001; odds ratio = 2.186; 95% confidence interval, 1.54-3.11). There was significantly greater morbidity among the younger cohort regarding cardiac arrest requiring cardiopulmonary resuscitation (P = 0.043; odds ratio = 0.099; 95% confidence interval, 0.014-0.704).
  
  
  CONCLUSIONS
  This is the first large study comparing the rates of postoperative complications of lumbar fusion surgery for spondylolisthesis in patients >80 years old versus younger patients. The data support that age alone should not exclude a patient for this procedure. However, extra caution is warranted given the slightly increased morbidity.
authors.affiliation: Department of Neurological Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Lieber
authors.affiliation: New York University School of Medicine, New York, New York, USA.
authors.forename: Vicky
authors.initials: V
authors.lastname: Chiang
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Arpan V
authors.initials: AV
authors.lastname: Prabhu
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: agarwaln@upmc.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: New York University School of Medicine, New York, New York, USA.
authors.forename: Jensen K
authors.initials: JK
authors.lastname: Henry
authors.affiliation: New York University College of Arts and Sciences, New York, New York, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Lin
authors.affiliation: Department of Neurological Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Noojan
authors.initials: N
authors.lastname: Kazemi
authors.affiliation: Department of Neurological Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Monir
authors.initials: M
authors.lastname: Tabbosha
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000706:statistics & numerical data*; D013168:Spondylolisthesis / Q000601:surgery*
keywords: Arthrodesis; Complications; Elderly; Single-level lumbar spine fusion; Spondylolisthesis