Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Spine Journal
Erschienen in: European Spine Journal 12/2012

01.12.2012 | Original Article

Lumbar spine fusion surgery and stroke: a national cohort study

verfasst von: Jau-Ching Wu, Yu-Chun Chen, Laura Liu, Wen-Cheng Huang, Peck-Foong Thien, Tzeng-Ji Chen, Henrich Cheng, Su-Shun Lo

Erschienen in: European Spine Journal | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the incidence and risk of stroke after lumbar spinal fusion surgery.

Method

Study subjects were identified from a nationwide cohort of 1 million people from 2000 to 2005 and were divided into the lumbar spinal fusion group (n = 2,015), who received posterior lumbar spinal fusion surgery, and the comparison group (n = 16,120) composed of age-, sex-, and propensity score-matched control subjects. The matching process was intended to adjust for demographics, comorbidities, and other immeasurable covariates to minimize selection bias. All subjects were followed up for 3 years for stroke, including hemorrhagic and ischemic strokes. Kaplan–Meier and Cox regression analyses were performed.

Results

The overall incidence rate of stroke in the cohort was 9.99 per 1,000 person-year. The lumbar spinal fusion group was less likely to have any stroke (adjusted hazard ratio (HR) = 0.83, p = 0.293), hemorrhagic stroke (adjusted HR = 0.74, p = 0.739) and ischemic stroke (adjusted HR = 0.81, p = 0.250) than the comparison group, but without significance.

Conclusions

Three years post-operatively, patients who received lumbar spinal fusion had stroke incidence rates similar to those without surgery. Posterior lumbar spinal fusion surgery is not associated with increased risks for any kind of stroke.
Literatur
1.
Larsen SF, Zaric D, Boysen G (1988) Postoperative cerebrovascular accidents in general surgery. Acta Anaesthesiol Scand 32(8):698–701PubMedCrossRef
2.
Newman NJ (2008) Perioperative visual loss after nonocular surgeries. Am J ophthalmol 145(4):604–610PubMedCrossRef
3.
Carl A, Kaufman E, Lawrence J (2010) Complications in spinal deformity surgery: issues unrelated directly to intraoperative technical skills. Spine (Phila Pa 1976) 35(25):2215–2223CrossRef
4.
Faciszewski T, Winter RB, Lonstein JE, Denis F, Johnson L (1995) The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults. A review of 1,223 procedures. Spine (Phila Pa 1976) 20(14):1592–1599CrossRef
5.
Ramirez LF, Thisted R (1989) Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals. Neurosurgery 25(2):226–230PubMedCrossRef
6.
Raffo CS, Lauerman WC (2006) Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade. Spine (Phila Pa 1976) 31(1):99–103CrossRef
7.
Shen Y, Silverstein JC, Roth S (2009) In-hospital complications and mortality after elective spinal fusion surgery in the United States: a study of the nationwide inpatient sample from 2001 to 2005. J Neurosurg Anesthesiol 21(1):21–30PubMedCrossRef
8.
Katz JN, Lipson SJ, Chang LC, Levine SA, Fossel AH, Liang MH (1996) Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine (Phila Pa 1976) 21(1):92–98CrossRef
9.
Fokter SK, Yerby SA (2006) Patient-based outcomes for the operative treatment of degenerative lumbar spinal stenosis. Eur Spine J 15(11):1661–1669PubMedCrossRef
10.
Khong P, Jerry Day M (2009) Spontaneous cerebellar haemorrhage following lumbar fusion. J Clin Neurosci 16(12):1673–1675PubMedCrossRef
11.
Zimmerman RM, Kebaish KM (2007) Intracranial hemorrhage following incidental durotomy during spinal surgery. A report of four patients. J Bone Joint Surg Am 89(10):2275–2279PubMedCrossRef
12.
Andrews RT, Koci TM (1995) Cerebellar herniation and infarction as a complication of an occult postoperative lumbar dural defect. AJNR Am J Neuroradiol 16(6):1312–1315PubMed
13.
Konya D, Ozgen S, Pamir MN (2006) Cerebellar hemorrhage after spinal surgery: case report and review of the literature. Eur Spine J 15(1):95–99PubMedCrossRef
14.
Beier AD, Soo TM, Claybrooks R (2009) Subdural hematoma after microdiscectomy: a case report and review of the literature. Spine J 9(10):e9–e12PubMedCrossRef
15.
Huber JF, Grob D (1998) Bilateral cortical blindness after lumbar spine surgery. A case report. Spine (Phila Pa 1976) 23(16):1807–1809CrossRef
16.
Wen CP, Tsai SP, Chung WS (2008) A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity. Ann Intern Med 148(4):258–267PubMed
17.
Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML (2011) Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf 20(3):236–242PubMedCrossRef
18.
Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36(1):8–27PubMedCrossRef
19.
Halfon P, Eggli Y, van Melle G, Chevalier J, Wasserfallen JB, Burnand B (2002) Measuring potentially avoidable hospital readmissions. J Clin Epidemiol 55(6):573–587PubMedCrossRef
20.
Lin HC, Chao PZ, Lee HC (2008) Sudden sensorineural hearing loss increases the risk of stroke: a 5-year follow-up study. Stroke 39(10):2744–2748PubMedCrossRef
21.
Baig MN, Lubow M, Immesoete P, Bergese SD, Hamdy EA, Mendel E (2007) Vision loss after spine surgery: review of the literature and recommendations. Neurosurg Focus 23(5):E15PubMedCrossRef
22.
Cheng MA, Sigurdson W, Tempelhoff R, Lauryssen C (2000) Visual loss after spine surgery: a survey. Neurosurgery 46(3):625–631PubMedCrossRef
23.
Katz DA, Karlin LI (2005) Visual field defect after posterior spine fusion. Spine (Phila Pa 1976) 30(3):E83CrossRef
24.
Cahill KS, Chi JH, Day A, Claus EB (2009) Prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins in spinal fusion procedures. JAMA 302(1):58–66PubMedCrossRef
25.
Winter RB (1997) Neurologic safety in spinal deformity surgery. Spine (Phila Pa 1976) 22(13):1527–1533CrossRef
26.
Castro FP Jr (2004) Role of activated growth factors in lumbar spinal fusions. J Spinal Disord Tech 17(5):380–384PubMedCrossRef
27.
Lee IM, Paffenbarger RS Jr (1998) Physical activity and stroke incidence: the Harvard Alumni Health Study. Stroke 29(10):2049–2054PubMedCrossRef
28.
Wannamethee G, Shaper AG (1992) Physical activity and stroke in British middle aged men. BMJ 304(6827):597–601PubMedCrossRef
29.
Wendel-Vos GC, Schuit AJ, Feskens EJ, Boshuizen HC, Verschuren WM, Saris WH, Kromhout D (2004) Physical activity and stroke. A meta-analysis of observational data. Int J Epidemiol 33(4):787–798PubMedCrossRef
30.
Lee CD, Folsom AR, Blair SN (2003) Physical activity and stroke risk: a meta-analysis. Stroke 34(10):2475–2481PubMedCrossRef
31.
Hu FB, Stampfer MJ, Colditz GA, Ascherio A, Rexrode KM, Willett WC, Manson JE (2000) Physical activity and risk of stroke in women. JAMA 283(22):2961–2967PubMedCrossRef
32.
Sattelmair JR, Kurth T, Buring JE, Lee IM (2010) Physical activity and risk of stroke in women. Stroke 41(6):1243–1250PubMedCrossRef
33.
Agnarsson U, Thorgeirsson G, Sigvaldason H, Sigfusson N (1999) Effects of leisure-time physical activity and ventilatory function on risk for stroke in men: the Reykjavik Study. Ann Intern Med 130(12):987–990PubMed
34.
Hu G, Sarti C, Jousilahti P, Silventoinen K, Barengo NC, Tuomilehto J (2005) Leisure time, occupational, and commuting physical activity and the risk of stroke. Stroke 36(9):1994–1999PubMedCrossRef
35.
Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD, Culebras A, Degraba TJ, Gorelick PB, Guyton JR, Hart RG, Howard G, Kelly-Hayes M, Nixon JV, Sacco RL (2006) Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council. Stroke 37(6):1583–1633PubMed
36.
Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA (2011) Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42(2):517–584PubMedCrossRef
Metadaten
Titel
Lumbar spine fusion surgery and stroke: a national cohort study
verfasst von
Jau-Ching Wu
Yu-Chun Chen
Laura Liu
Wen-Cheng Huang
Peck-Foong Thien
Tzeng-Ji Chen
Henrich Cheng
Su-Shun Lo
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 12/2012
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2405-x

Weitere Artikel der Ausgabe 12/2012

European Spine Journal 12/2012 Zur Ausgabe

Original Article

Cross-cultural adaptation and validation of the Norwegian version of the Core Outcome Measures Index for low back pain

Original Article

Posterior lumbar spinal fusion and instrumentation in morbidly obese patients using the Synframe retractor system: technical note

Original Article

Late infections after dynamic stabilization of the lumbar spine with Dynesys

Open Operating Theatre (OOT)

Cervical osteotomy in Ankylosing Spondylitis

Original Article

Three- and four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct

Original Article

The effects of upper limb loading on spinal shrinkage during treadmill walking

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise