title: Complications of spinal surgery for elderly patients with lumbar spinal stenosis in a super-aging country: An analysis of 8033 patients.
abstract: BACKGROUND
  The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years.
  
  
  METHODS
  A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data. Data were returned by the end of May 2012.
  
  
  RESULTS
  Data were accumulated for 8033 patients aged 65 years. The incidence of surgical complications was 10.8%, and did not differ significantly between age groups. The incidence of general complications was 2.7%, and differed significantly between age groups (p < 0.005). The highest incidence of surgical complications was for dural tear (DT) (3.6%), followed by deep wound infection (DWI) (1.4%), neurological complications (1.3%), and epidural hematoma (1.3%). Spinal instrumentation was applied in 30.3%. Incidences of surgical complications in instrumented and noninstrumented surgery were 17.3% and 8.8%. In instrumented surgery, incidences of surgical and general complications were higher in the ≥80 year age group than in the 65-79 year age group. Logistic regression analyses showed patients with microendoscopic surgery at increased risk of DT. Patients with diabetes mellitus and instrumented surgery showed increased risks of DWI.
  
  
  CONCLUSIONS
  Incidences of surgical complications did not differ significantly between age groups. Attention should be paid to both surgical and general complications, particularly for postoperative mental disease in instrumented surgery for patients≥80 years old.
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan. Electronic address: i-yasuak@yamaguchi-u.ac.jp.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Imajo
authors.affiliation: Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Department of Orthopedic Surgery, Osaka Medical College, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Neo
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Fukushima Medical University, School of Medicine, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Otani
authors.affiliation: Spine Center, Ehime University Hospital, Japan.
authors.forename: Tadanori
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ozawa
authors.affiliation: Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science Kanazawa University, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Iguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D016208:Databases, Factual; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011247:Pregnancy; D018570:Risk Assessment; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000503:physiopathology; D016896:Treatment Outcome