gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Dorsal instrumentation of cervical spine in geriatric patients does not impact patient safety: experience at a level 1 center for spinal surgery – a single centre cohort study

Dorsale Zervikale Stabilisierung in geriatrischen Patienten: Erfahrung eines Level 1 Zentrums für Wirbelsäulenchirurgie

Meeting Abstract

  • presenting/speaker Ehab Shabo - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Simon Brandecker - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Shaleen Rana - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Gregor Bara - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Jasmin Scorzin - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Lars Eichhorn - University Hospital Bonn, Department of Anesthesiology and Intensive Care Medicine, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Mohammed Banat - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP139

doi: 10.3205/22dgnc452, urn:nbn:de:0183-22dgnc4528

Published: May 25, 2022

© 2022 Shabo et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Dorsal instrumentation of the cervical spine is an established treatment in spinal surgery, but careful planning is required, particularly in the case of older patients. This study evaluates early clinical outcomes in geriatric patients undergoing complex spinal surgery.

Methods: In this retrospective, single-center cohort study, we included all geriatric patients (aged ≥65 years) who underwent dorsal instrumentation between January 2013 and December 2020. We analyzed postoperative complications and the 30 days in-hospital mortality rate. Furthermore, the Charlson comorbidity index (CCI) and Clavien-Dindo grading system (CDG) were used to assess the patients' comorbidity burden.

Results: In total, 153 patients were identified and included. The mean age of patients was 78 years (SD±7). Traumatic injury (53.6%) was the most common reason for surgery. 60.8% of the patients underwent dorsal instrumentation with 3 or more levels. The most common comorbidities were arterial hypertension (64%), Diabetes mellitus (22.2%), Coronary heart disease and Atrial fibrillation (19.6%). The most common adverse event was pneumonia (4%) and the most common surgery-related complication was wound infection (5.2%). Among patients categorized as high risk group for AE (CCI >5), 14.6% suffered a postoperative AE. In our univariate analysis, we found no risk factors for high rates of complications or mortality.

Conclusion: Our data demonstrate that older patients were at no significant risk of postoperative complications. The CCI/CDG may identify patients at higher risk for adverse events after dorsal instrumentation in the cervical spine surgery, and it should become an essential component of stratification in this aging patient population.

Table 1 [Tab. 1], Table 2 [Tab. 2]