OBJECTIVE: Lumbar surgery with transpedicular instrumentation allows adequate fusion to stabilize the affected vertebral segments and favors arthrodesis. Most of cases required complexes and prolonged procedures in elderly patients with multiple comorbidities. The extent of levels submitted to decompression and fusion is not always consensual. The authors intend to determine whether a relationship exists between the operated levels and the complication rate intra- and postoperatively. METHODS: This is a retrospective study including 50 subjects with lumbar stenosis submitted to surgery between 2009 and 2010. The mean age of the group was 65.98±8.82 years old. The number of instrumented levels (IL) and decompressed levels (DL) was determined. Variables included were: time in postanesthesia care unit (PACU); blood transfusions (BT); hemoglobin loss (Hgb); surgery time in minutes; days of hospitalization; and ASA score (American Society of Anesthesiologists). Neurologic complications, infectious, vascular complications, incorrect screw placement and re-operated patients were also assessed. Two groups: Group A (IL ≤3) and Group B (IL>3) .Statistical analysis with SPSS19®. RESULTS: Increased IL and DL related with increased need of BT, longer time in PACU; greater loss of Hgb and increased surgical time (p<0,05). DL and IL associated with more complications (p<0,05). Group A vs Group B: Group B - increased need of BT (p<0,05); longer PACU time (p<0,05); greater Hgb loss (p<0,05); longer surgical time (p<0,05); higher complication rate (p<0,05). CONCLUSION: This overall rate of complications should be used to better inform patients about surgery risks and in surgery planning, particularly in older patients with comorbidities. Care must be taken when performing three levels of fusion/decompression or more.
Spinal stenosis; Intraoperative complications; Postoperative complications; Spinal fusion; Spine
