Lumbar spinal fusion has become more popular for degenerative conditions of the spine associated with aging. Studies show that this procedure is both safe and effective. But, as with any operation, there can be complications and problems that develop as a result of the hospitalization, surgery, and all that goes with those two things.
Sometimes it’s not clear why a particular patient developed complications. In other cases, there is a more identifiable reason. For example, patients with high blood pressure or diabetes are known to be at increased risk of problems when having orthopedic surgery such as a spinal fusion.
A recent study was done at Stanford University to help sort out some of the possible risk factors for in-hospital complications linked with lumbar fusion. They analyzed the data on over 66,000 patients who had posterior spinal fusion. The patients were all diagnosed with one particular spinal problem called acquired spondylolisthesis. This condition is also known as degenerative spondylolisthesis.
Acquired spondylolisthesis is usually a condition seen in older adults (though it can be seen in younger individuals). Acquired means it’s something that happens to the person, rather than being a condition he or she was born with. When spondylolisthesis occurs in childhood, it is usually as a result of an injury. In older adults, degeneration of the disc and facet (spinal) joints can lead to spondylolisthesis.
Spondylolisthesis describes a condition of the spine in which one of the vertebral bones in the lumbar spine (low back) slips forward over the one below it. As the bones shift, the spinal canal opening (where the spinal cord is located) narrows. The result can be pressure on the spinal cord or peripheral nerves leaving the spinal cord in the lumbar region. Back, buttock, and leg pain are the main symptoms of this condition. Over time, leg weakness may also develop.
Complications from this procedure range from minor to major but the overall complication rate nationwide is 11 per cent. That’s pretty high but fortunately less than one per cent are life-threatening resulting in death. Hematomas (pocket of blood at the surgical site) were shown to be the main problem. These are usually fairly minor.
More serious complications included blood clots, heart attacks, kidney infections or kidney failure, and less often, neurologic problems. Patients 65 years old and older were much more likely to develop complications. Anyone with more than one medical problem was also at increased risk of post-operative complications. If your brother is 65 or older and has some significant other health problems, these two factors could explain why he had so many problems.