Surgical Risk

Any surgery carries risks, and surgical procedures on the lumbar spine are significant undertakings. A recently published study examined the overall risks associated with lumbar surgery and found that many of them are more associated with age and general health problems than with the specific lumbar condition.

The study reviewed results with 12,00 patients who had undergone lumbar spine surgery at Veterans Affairs hospitals over a period of 11 years. This included different procedures, but all were dealing with the spinal stenosis that commonly produces back and leg pain and which is the primary reason for lumbar surgery in older adults.

The risk for major problems such as stroke, heart attack, and systemic infection following lumbar surgery was 2.1%, while wound complications at the surgical site occurred in 3.2% of the cases. However, these rates varied significantly according the patients’ ages, with major complications occurring in less than 1% of cases for patients under 50 years of age. This rate more than quadrupled for patients over 80 years old.

The extent of the surgery was also a significant risk factor. Spinal decompression surgery such as diskectomy, laminectomy, or osteophy removal was substantially less dangerous — only one-third the rate for major complication — as compared to more complex procedures such as spinal fusion.

General health problems such as diabetes, chronic lung disease, and cardiovascular disease were also significant risk factors.

The need for lumbar surgery correlates strongly with a patient’s age — the greater a patient’s age, the more advanced will be the natural degeneration of the spinal structures and the more susceptible they will be to traumatic injury as compared to younger patients. This being the case, these factors related to age and general health should be carefully considered when weighing surgery as a treatment option.