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The Journal of Bone and Joint Surgery, Vol 74, Issue 4 536-543, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure
RA Deyo, DC Cherkin, JD Loeser, SJ Bigos and MA Ciol
Department of Medicine, University of Washington, Seattle 98195.
We examined the rates of postoperative complications and mortality, as
recorded in a hospital discharge registry for the State of Washington for
the years 1986 through 1988, for patients who had had an operation on the
lumbar spine. When patients who had had a malignant lesion, infection, or
fracture are excluded, there were 18,122 hospitalizations for procedures on
the lumbar spine, 84 per cent of which involved a herniated disc or spinal
stenosis. The rates of morbidity and mortality during hospitalization, as
well as the hospital charges, increased with the ages of the patients. The
rate of complications was 18 per cent for patients who were seventy-five
years or older. Nearly 7 per cent of patients who were seventy-five years
old or more were discharged to nursing homes. Complications were most
frequent among patients who had spinal stenosis, but multivariate analysis
suggested that the complications associated with procedures for this
condition were primarily related to the patient's age and the type of
procedure. Complications, length of hospitalization, and charges were
higher for patients who had had a spinal arthrodesis than for those who had
not. Over-all, operations for conditions other than a herniated disc were
associated with more complications and greater use of resources,
particularly when arthrodesis was performed, than were operations for
removal of a herniated disc. No data on symptoms or functional results were
available.
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