0
Journal Contents   |    
Complications after Low-Back Fusion in 1000 Patients A COMPARISON OF TWO SERIES ONE DECADE APART
S. RICHARD PROTHERO; JAMES C. PARKES; FRANK E. STINCHFIELD
View Disclosures and Other Information
From The New York Orthopaedic Dispensary and Hospital, New York
1966 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1966; 48:57-65 
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case
text A A A

Abstract

1. The complications after low-back fusion in two series of 500 cases each, one decade apart, were analyzed and compared.

2. The most common complication was urinary retention. Prophylactic sulfonamide therapy after catheterization prevented subsequent urinary tract infection.

3. The over-all incidence of thromboembolic complications was 3.2 per cent. The incidence decreased from 4.2 in the first to 2.2 per cent in the second series concomitantly with, and probably as a result of, earlier walking.

4. The immediate institution of anticoagulant therapy following the diagnosis of thromboembolism resulted in complete recovery in the thirty-two cases in the combined series.

5. The incidence of thromboembolic complications was found to be slightly higher in older patients and in those with prior history of peripheral vascular disease.

6. Peripheral phlebothrombosis developed on the side from which the iliaccrest graft was taken in 67 per cent of cases.

7. Wound infection as a complication of spine fusion occurred in 3.4 per cent of our patients.

8. Increased operating time and early ambulation after spine fusion did not appear to increase the risk of infection.

9. Postoperative antibiotic prophylaxis did not decrease the incidence of infection and may have increased the risk.

10. Pseudarthrosis developed in 15.1 per cent of the 430 cases followed, with the lowest rates following fusion by the H-graft and lateral-element techniques.

11. Pseudarthrosis developed in only 10.3 per cent of the multiple-joint fusions in which the lateral-element technique was employed.

12. The incidence of pseudarthrosis increased as the number of vertebrae in the fusion mass increased.

13. Earlier walking did not increase the incidence of pseudarthrosis.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

    Topics

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe




    Related Articles
    Related Cases
    Related Content
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    A rare anterior sacral osteochondroma presenting as sciatica in an adult: a case report and review of the literature.
    The spine journal : official journal of the North American Spine Society: Issue date- 2010 May
    Olfactory stem cells can be induced to express chondrogenic phenotype in a rat intervertebral disc injury model.
    The spine journal : official journal of the North American Spine Society: Issue date- 2009 Jul
    Clinical Trials
    Readers of This Also Read...
    jbjs jobs
    12/22/2011
    ME - Central Maine Medical Center
    12/22/2011
    VA - Charleston Area Medical Center
    12/22/2011
    Maine - Central Maine Medical Center