Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Kazuyoshi Kobayashi¹, Shiro Imagama¹, Kei Ando¹, Naoki Ishiguro¹, Masaomi Yamashita², Yawara Eguchi³, Morio Matsumoto⁴, Ken Ishii⁴, Tomohiro Hikata⁴, Shoji Seki⁵, Hidetomi Terai⁶, Akinobu Suzuki⁶, Koji Tamai⁶, Masaaki Aramomi⁷, Tetsuhiro Ishikawa⁷, Atsushi Kimura⁸, Hirokazu Inoue⁸, Gen Inoue⁹, Masayuki Miyagi⁹, Wataru Saito⁹, Kei Yamada¹⁰, Michio Hongo¹¹, Hirosuke Nishimura¹², Hidekazu Suzuki¹², Atsushi Nakano¹³, Kazuyuki Watanabe¹⁴, Hirotaka Chikuda¹⁵, Junichi Ohya¹⁵, Yasuchika Aoki¹⁶, Masayuki Shimizu¹⁷, Toshimasa Futatsugi¹⁷, Keijiro Mukaiyama¹⁷, Masaichi Hasegawa¹⁸, Katsuhito Kiyasu¹⁹, Haku Iizuka²⁰, Yoichi Iizuka²⁰, Ryoichi Kobayashi²⁰, Kotaro Nishida²¹, Kenichiro Kakutani²¹, Hideaki Nakajima²², Hideki Murakami²³, Satoru Demura²³, Satoshi Kato²³, Katsuhito Yoshioka²³, Takashi Namikawa²⁴, Kei Watanabe^{25

26}, Kazuyoshi Nakanishi²⁷, Yukihiro Nakagawa²⁸, Mitsunori Yoshimoto²⁹, Hiroyasu Fujiwara³⁰, Norihiro Nishida³¹, Yasuaki Imajo³¹, Masashi Yamazaki³², Masataka Sakane³², Tetsuya Abe³², Kengo Fujii³², Takashi Kaito³³, Takeo Furuya³⁴, Sumihisa Orita³⁴, Seiji Ohtori³⁴

Affiliations

¹ Nagoya University, Nagoya, Japan.
² Japan Community Health Care Organization Funabashi Central Hospital, Chiba, Japan.
³ Shimoshizu National Hospital, Chiba, Japan.
⁴ Keio University School of Medicine, Tokyo, Japan.
⁵ University of Toyama, Toyama, Japan.
⁶ Osaka City University, Osaka, Japan.
⁷ Sanmu Medical Center, Chiba, Japan.
⁸ Jichi Medical University, Tochigi, Japan.
⁹ Kitasato University, Kanagawa, Japan.
¹⁰ Kurume University, Fukuoka, Japan.
¹¹ Akita University, Akita, Japan.
¹² Tokyo Medical University, Tokyo, Japan.
¹³ Osaka Medical College, Osaka, Japan.
¹⁴ Fukushima Medical University, Fukushima, Japan.
¹⁵ The University of Tokyo, Tokyo, Japan.
¹⁶ Eastern Chiba Medical Center, Togane, Japan.
¹⁷ Shinshu University, Nagano, Japan.
¹⁸ Kyorin University, Tokyo, Japan.
¹⁹ Kochi University, Kochi, Japan.
²⁰ Gunma University Graduate School of Medicine, Gunma, Japan.
²¹ Kobe University, Hyogo, Japan.
²² University of Fukui, Fukui, Japan.
²³ Kanazawa University, Kanazawa, Ishikawa, Japan.
²⁴ Osaka City General Hospital, Osaka, Japan.
²⁵ Niigata University, Niigata, Japan.
²⁶ Sado General Hospital, Niigata, Japan.
²⁷ Hiroshima University, Hiroshima, Japan.
²⁸ Wakayama Medical University, Wakayama, Japan.
²⁹ Sapporo Medical University, Hokkaido, Japan.
³⁰ Osaka-Minami Medical Center, Osaka, Japan.
³¹ Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
³² University of Tsukuba, Tsukuba, Ibaraki, Japan.
³³ Osaka University Graduate School, Osaka, Japan.
³⁴ Chiba University, Chiba, Japan.

PMID: 28989842
PMCID: PMC5624380
DOI: 10.1177/2192568217716144

Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Kazuyoshi Kobayashi et al. Global Spine J. 2017 Oct.

. 2017 Oct;7(7):636-641.

doi: 10.1177/2192568217716144. Epub 2017 Jul 20.

Authors

Affiliations

¹ Nagoya University, Nagoya, Japan.
² Japan Community Health Care Organization Funabashi Central Hospital, Chiba, Japan.
³ Shimoshizu National Hospital, Chiba, Japan.
⁴ Keio University School of Medicine, Tokyo, Japan.
⁵ University of Toyama, Toyama, Japan.
⁶ Osaka City University, Osaka, Japan.
⁷ Sanmu Medical Center, Chiba, Japan.
⁸ Jichi Medical University, Tochigi, Japan.
⁹ Kitasato University, Kanagawa, Japan.
¹⁰ Kurume University, Fukuoka, Japan.
¹¹ Akita University, Akita, Japan.
¹² Tokyo Medical University, Tokyo, Japan.
¹³ Osaka Medical College, Osaka, Japan.
¹⁴ Fukushima Medical University, Fukushima, Japan.
¹⁵ The University of Tokyo, Tokyo, Japan.
¹⁶ Eastern Chiba Medical Center, Togane, Japan.
¹⁷ Shinshu University, Nagano, Japan.
¹⁸ Kyorin University, Tokyo, Japan.
¹⁹ Kochi University, Kochi, Japan.
²⁰ Gunma University Graduate School of Medicine, Gunma, Japan.
²¹ Kobe University, Hyogo, Japan.
²² University of Fukui, Fukui, Japan.
²³ Kanazawa University, Kanazawa, Ishikawa, Japan.
²⁴ Osaka City General Hospital, Osaka, Japan.
²⁵ Niigata University, Niigata, Japan.
²⁶ Sado General Hospital, Niigata, Japan.
²⁷ Hiroshima University, Hiroshima, Japan.
²⁸ Wakayama Medical University, Wakayama, Japan.
²⁹ Sapporo Medical University, Hokkaido, Japan.
³⁰ Osaka-Minami Medical Center, Osaka, Japan.
³¹ Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
³² University of Tsukuba, Tsukuba, Ibaraki, Japan.
³³ Osaka University Graduate School, Osaka, Japan.
³⁴ Chiba University, Chiba, Japan.

PMID: 28989842
PMCID: PMC5624380
DOI: 10.1177/2192568217716144

Abstract

Study design: Retrospective study of registry data.

Objectives: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions.

Methods: A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury.

Results: Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P = .004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P = .007) was significantly associated with major complications.

Conclusions: Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients.

Keywords: complications; elderly; risk factor; spine surgery.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Figure 1.**
Bar graph showing the population stratified by age.

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Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Affiliations

Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

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Abstract

Conflict of interest statement

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