Uchenna Ajoku, Michael G. Johnson, Greg McIntosh, Ken Thomas, Christopher S. Bailey, Hamilton Hall, Charles G. Fisher, Neil Manson, Y. Raja Rampersaud, Nicolas Dea, Sean Christie, Edward Abraham, Michael H. Weber, Raphaele Charest-Morin, Najmedden Attabib, André le Roux, Philippe Phan, Jerome Paquet, Peter Lewkonia, Michael Goytan


October 2023, Volume 32, Issue 10, pp 3583 - 3590 Original Article Read Full Article 10.1007/s00586-023-07882-3

First Online: 18 August 2023

Study design

An ambispective review of consecutive cervical spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) between January 2015 and September 2019.

Purpose

To compare complication rates of degenerative cervical spine surgery over time between older (> 65) and younger age groups (< 65).

Summary of background data

More elderly people are having spinal surgery. Few studies have examined the temporal nature of complications of cervical spine surgery by patient age groups.

Methods

Adverse events were collected prospectively using adverse event forms. Binary logistic regression analysis was utilized to assess associations between risk modifiers and adverse events at the intra-, peri-operative and 3 months post-surgery.

Results

Of the 761 patients studied (age < 65, n = 581 (76.3%) and 65 + n = 180 (23.7%), the intra-op adverse events were not significantly different; < 65 = 19 (3.3%) vs 65 +  = 11 (6.1%), p < 0.087. Peri-operatively, the < 65 group had significantly lower percentage of adverse events (65yrs (11.2%) vs. 65 +  = (26.1%), p < 0.001). There were no differences in rates of adverse events at 3 months post-surgery (< 65 = 39 (6.7%) vs. 65 +  = 12 (6.7%), p < 0.983). Less blood loss (OR = 0.99, p < 0.010) and shorter length of hospital stay (OR = 0.97, p < 0.025) were associated with not having intra-op adverse events. Peri-operatively, > 1 operated level (OR = 1.77, p < 0.041), shorter length of hospital stay (OR = 0.86, p < 0.001) and being younger than 65 years (OR = 2.11, p < 0.006) were associated with not having adverse events.

Conclusion

Following degenerative cervical spine surgery, the older and younger age groups had significantly different complication rates at peri-operative time points, and the intra-operative and 3-month post-operative complication rates were similar in the groups.


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