Risk factors for delayed extubation in thoracic and lumbar spine surgery: a retrospective analysis of 135 patients

2013 ◽  
Vol 28 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Fenghua Li ◽  
Reza Gorji ◽  
Richard Tallarico ◽  
Charles Dodds ◽  
Katharina Modes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Thoracic And Lumbar Spine ◽  
Delayed Extubation

scholarly journals Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

2021 ◽  
Author(s):  
Alice Giotta Lucifero ◽  
Cristian Gragnaniello ◽  
Matias Baldoncini ◽  
Alvaro Campero ◽  
Gabriele Savioli ◽  
...  
Keyword(s):  
At Risk ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Iliac Vein ◽  
Lumbar Spine Surgery ◽  
Common Iliac Vein ◽  
Suture Repair ◽  
Vascular Injuries ◽  
Mesh Terms ◽  
Thoracic And Lumbar Spine

Abstract Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

Incidence and Risk Factors for Postoperative Delirium After Lumbar Spine Surgery

Spine ◽  
2013 ◽  
Vol 38 (20) ◽  
pp. 1790-1796 ◽  
Author(s):  
Steven J. Fineberg ◽  
Sreeharsha V. Nandyala ◽  
Alejandro Marquez-Lara ◽  
Matthew Oglesby ◽  
Alpesh A. Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Postoperative Delirium ◽  
Lumbar Spine Surgery

The Effect of Vancomycin Powder on the Rates of Infection and Pseudarthrosis in Lumbar Spine Surgery: A Retrospective Analysis of 453 Patients

2016 ◽  
Vol 16 (10) ◽  
pp. S273
Author(s):  
Sukanta Maitra ◽  
Jordan Kump ◽  
Zach Lee ◽  
Yue Zhang ◽  
Stephen Pehler ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Vancomycin Powder

Postoperative Visual Loss Following Lumbar Spine Surgery: A Review of Risk Factors by Diagnosis

2015 ◽  
Vol 84 (6) ◽  
pp. 2010-2021 ◽  
Author(s):  
Amy Li ◽  
Christian Swinney ◽  
Anand Veeravagu ◽  
Inderpreet Bhatti ◽  
John Ratliff
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Visual Loss ◽  
Lumbar Spine Surgery ◽  
Postoperative Visual Loss

scholarly journals Economic analysis of 90-day return to the emergency room and readmission after elective lumbar spine surgery: a single-center analysis of 5444 patients

2021 ◽  
Vol 34 (1) ◽  
pp. 89-95
Author(s):  
Marcel R. Wiley ◽  
Leah Y. Carreon ◽  
Mladen Djurasovic ◽  
Steven D. Glassman ◽  
Yehia H. Khalil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Emergency Room ◽  
Spine Surgery ◽  
Administrative Databases ◽  
Lumbar Spine Surgery ◽  
Chronic Obstructive ◽  
Multiple Chronic Conditions ◽  
Single Center ◽  
Patient Counseling

OBJECTIVEIn the future, payers may not cover unplanned 90-day emergency room (ER) visits or readmissions after elective lumbar spine surgery. Prior studies using large administrative databases lack granularity and/or use a proxy for actual cost. The purpose of this study was to identify risk factors and subsequent costs associated with 90-day ER visits and readmissions after elective lumbar spine surgery.METHODSA prospective, multisurgeon, single-center electronic medical record was queried for elective lumbar spine fusion surgeries from 2013 to 2017. Predictive models were created for 90-day ER visits and readmissions.RESULTSOf 5444 patients, 729 (13%) returned to the ER, most often for pain (n = 213, 29%). Predictors of an ER visit were prior ER visit (OR 2.5), underserved zip code (OR 1.4), and number of chronic medical conditions (OR 1.4). In total, 421 (8%) patients were readmitted, most frequently for wound infection (n = 123, 2%), exacerbation of chronic obstructive pulmonary disease (n = 24, 0.4%), and sepsis (n = 23, 0.4%). Predictors for readmission were prior ER visit (OR 1.96), multiple chronic conditions (OR 1.69), obesity (nonobese, OR 0.49), race (African American, OR 1.43), admission status (ER admission, OR 2.29), and elevated hemoglobin A1c (OR 1.80). The mean direct hospital cost for an ER visit was $1971, with 75% of visits costing less than $1890, and the average readmission cost was $7347, with 75% of readmissions costing less than $8820. Over the 5-year study period, the cost to the institution for 90-day return ER visits was $5.1 million.CONCLUSIONSRisk factors for 90-day ER visit and readmission after elective lumbar spine surgery include medical comorbidities and socioeconomic factors. Proper patient counseling, appropriate postoperative pain management, and optimization of modifiable risk factors prior to surgery are areas to focus future efforts to lower 90-day ER visits and readmissions and reduce healthcare costs.

P88 Identifying risk factors for multiple revisional lumbar spine surgery

2019 ◽  
Vol 90 (3) ◽  
pp. e45.1-e45
Author(s):  
M El Sheikh ◽  
K Badran ◽  
O Kouli ◽  
M Abdelsadg ◽  
M Fadelalla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Morbidity Rate ◽  
Lumbar Spine Surgery ◽  
Neurosurgical Department ◽  
Primary Surgery ◽  
Diabetes Status

ObjectivesRecurrent lumbar spine surgery due to disc herniation is a contributor to debilitating pain, disability, and carries a high patient morbidity rate1 We identified risk factors for recurrent lumbar disc herniation post-surgical intervention.DesignRetrospective Cohort Study.SubjectsAll adult lumbar spine revisions for disc herniation performed in the Neurosurgical Department at Ninewells Hospital.MethodsThe number of revisions from 2013 to 2017 for each patient was recorded and two groups were identified. The first group consisted of patients who had one revision and the second group consisted of patients who had recurrent revisions (more than one) Possible factors influencing the likelihood of recurrent revisions were also noted, including age, gender, BMI, operation length, level of surgery, time from primary surgery to revision, smoking and diabetes status.Results140 patients had revision surgeries, of which 87 (62.1%) had one revision while 53 (37.1%) had recurrent operations. Younger patients (p=0.025) and patients with higher BMI (p=0.01) were more likely to have a higher number of revisions. Patients with DM (p=0.015) were associated with a higher likelihood of recurrent revisions. Other factors had little effect on the likelihood of recurrent revisions (p>0.05).ConclusionsIdentifying risk factors that influence the recurrence of lumbar revisions helps improve patient outcome and decrease incidence of revisions.

scholarly journals Postoperative Spinal Subdural Lesions Following Lumbar Spine Surgery: Prevalence and Risk Factors

2017 ◽  
Vol 11 (5) ◽  
pp. 793-803 ◽  
Author(s):  
Yukitaka Nagamoto ◽  
Shota Takenaka ◽  
Hiroyuki Aono
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Confidence Interval ◽  
Spine Surgery ◽  
Odds Ratio ◽  
Protective Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Lumbar Spine Surgery ◽  
Decompression Surgery ◽  
Mr Images

<sec><title>Study Design</title><p>Retrospective case–control study</p></sec><sec><title>Purpose</title><p>To clarify the prevalence and risk factors for spinal subdural lesions (SSDLs) following lumbar spine surgery.</p></sec><sec><title>Overview of Literature</title><p>Because SSDLs, including arachnoid cyst and subdural hematoma, that develop following spinal surgery are seldom symptomatic and require reoperation, there are few reports on these pathologies. No study has addressed the prevalence and risk factors for SSDLs following lumbar spine surgery.</p></sec><sec><title>Methods</title><p>We conducted a retrospective analysis of the magnetic resonance (MR) images and medical records of 410 patients who underwent lumbar decompression surgery with or without instrumented fusion for degenerative disorders. SSDLs were classified into three grades: grade 0, no obvious lesion; grade 1, cystic lesion; and grade 2, lesions other than a cyst. Grading was based on the examination of preoperative and postoperative MR images. The prevalence of SSDLs per grade was calculated and risk factors were evaluated using multivariate logistic regression analysis.</p></sec><sec><title>Results</title><p>Postoperative SSDLs were identified in 123 patients (30.0%), with 50 (12.2%) and 73 (17.8%) patients being classified with grade 1 and 2 SSDLs, respectively. Among these, one patient was symptomatic, requiring hematoma evacuation because of the development of incomplete paraplegia. Bilateral partial laminectomy was a significantly independent risk factor for SSDLs (odds ratio, 1.52; 95% confidence interval, 1.20–1.92; <italic>p</italic>&lt;0.001). In contrast, a unilateral partial laminectomy was a protective factor (odds ratio, 0.11; 95% confidence interval, 0.03–0.46; <italic>p</italic>=0.002).</p></sec><sec><title>Conclusions</title><p>The prevalence rate of grade 1 SSDLs was 30%, with no associated clinical symptoms observed in all but one patient. Bilateral partial laminectomy increases the risk for SSDLs, whereas unilateral partial laminectomy is a protective factor.</p></sec>

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