A multicenter study of 1‑year mortality and walking capacity after spinal fusion surgery for cervical fracture in elderly patients

BMC Musculoskeletal Disorders, 2022 · DOI: https://doi.org/10.1186/s12891-022-05752-5 · Published: August 9, 2022

Simple Explanation

This study investigates the outcomes of elderly patients who undergo spinal fusion surgery for cervical fractures, focusing on mortality and changes in walking ability one year after the surgery. The research identifies factors that are associated with increased mortality and deterioration in walking capacity, providing insights for surgeons and healthcare providers. The findings suggest that pre-existing health conditions, severity of spinal cord injury, surgical time, and the number of fused segments play a significant role in patient outcomes.

Study Duration

February 2010 to August 2019

Participants

313 patients aged 65 years or more with a traumatic cervical fracture

Evidence Level

Not specified

Key Findings

1
The 1-year mortality rate after spinal fusion surgery for cervical fractures in elderly patients was 8%.
2
A higher Charlson Comorbidity Index (CCI) score, a more severe American Spinal Cord Injury Association impairment scale (AIS), and longer surgical time were independent factors associated with increased 1-year mortality.
3
The rate of deterioration in walking capacity between pre-trauma and 1 year postoperatively was 33%, and was associated with a more severe AIS, lower albumin (Alb) and hemoglobin (Hb) values, and a larger number of fused segments.

Research Summary

This multicenter study analyzed data from 313 elderly patients who underwent spinal fusion surgery for cervical fractures to determine 1-year mortality and changes in walking capacity. The study found an 8% mortality rate and a 33% deterioration in walking capacity 1 year after surgery. Factors such as higher CCI score, severe AIS, longer surgical time, lower Alb and Hb values, and a larger number of fused segments were identified as independent predictors of mortality and walking capacity deterioration.

Practical Implications

Risk Stratification

Identify high-risk patients based on CCI, AIS, Alb, and Hb levels to optimize surgical planning and postoperative care.

Surgical Planning

Minimize surgical time and the number of fused segments to improve patient outcomes.

Postoperative Management

Implement aggressive management of comorbidities and nutritional support to reduce mortality and improve functional outcomes.

Study Limitations

1
Retrospective design with missing data.
2
Lack of detailed information on surgical techniques and postoperative treatment.
3
Potential selection bias due to loss to follow-up.

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