Lumbar spinal fusion. A cohort study of complications, reoperations, and resource use in the Medicare population.

摘要: Regional variations in lumbar spinal fusion rates suggest a poor consensus on surgical indications. Therefore, complications, costs, and reoperation were compared for elderly patients undergoing surgery with or without fusion. Subjects Medicare recipients who underwent 1985, 4 years of subsequent follow-up. There 27,111 eligible patients, whom 5.6% had fusions. Mean age was 72 years. Patients complication rate 1.9 times greater than those The blood transfusion 5.8 greater, nursing home placement 2.2 hospital charges 1.5 higher (all P < 0.0005). Six-week mortality 2.0 fusions (P = 0.025). Reoperation at no lower results similar most diagnostic subgroups. Indications among older require better definition, preferably based outcomes from prospective controlled studies.