Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources

Ole Kristian Alhaug; Filip C Dolatowski; Simran Kaur; Greger Lønne

doi:10.1007/s00701-024-06086-y

Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources

Acta Neurochir (Wien). 2024 Apr 23;166(1):189. doi: 10.1007/s00701-024-06086-y.

Authors

Ole Kristian Alhaug^{1

2}, Filip C Dolatowski³, Simran Kaur⁴, Greger Lønne⁵

Affiliations

¹ The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, PO Box 68, N-2313, Ottestad, Norway. olekralhaug@hotmail.com.
² Orthopaedic Department, Akershus University Hospital, PO Box 1000, N-1478, Loerenskog, Norway. olekralhaug@hotmail.com.
³ Orthopaedic Department, Oslo University Hospital, PO Box 4956, N-0424, Oslo, Norway.
⁴ Orthopedic Department, Martina Hansens Hospital, Dønskiveien 8, 1346, Gjettum, Norway.
⁵ Innlandet Hospital Trust, PO Box 104, N-2381, Brumunddal, Norway.

Abstract

Purpose: Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete. To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a sample of Norwegian LSS patients.

Methods: 474 patients treated surgically for LSS during 2015 and 2016 at four hospitals reported to a national spine registry (NORspine). Postoperative complications were recorded by patients in NORspine, and we cross-referenced complications documented in NORspine with the patients´ electronic patient records (EPR) to re-test the complication rates. We performed descriptive statistics of complication rates using the two different data sources above, and analyzed the association between postoperative complications and clinical outcome with logistic regression.

Results: The mean (95%CI) patient age was 66.3 (65.3-67.2) years, and 254 (53.6%) were females. All patients were treated with decompression, and 51 (10.7%) received an additional fusion during the index surgery. Combining the two data sources, we found a total rate for postoperative complications of 22.4%, the NORspine registry reported a complication rate of 15.6%, and the EPR review resulted in a complication rate of 16.0%. However, the types of complications were inconsistent across the two data sources. According to NORspine, the frequency of reoperation within 90 days was 0.9% and according to EPR 3.4%. The rates of wound infection were for NORspine 3.1% and EPR review 2.1%. There was no association between postoperative complication and patient reported outcome.

Conclusion: Postoperative complications occurred in 22% of LSS patients. The frequency of different postoperative complications differed between the two data sources.

Keywords: Data accuracy; Electronic patient record; Lumbar spinal stenosis; Postoperative complications; Spine registry.

MeSH terms

Aged
Decompression, Surgical* / adverse effects
Decompression, Surgical* / methods
Female
Humans
Information Sources
Lumbar Vertebrae* / surgery
Male
Middle Aged
Norway / epidemiology
Postoperative Complications* / epidemiology
Postoperative Complications* / etiology
Registries*
Spinal Fusion* / adverse effects
Spinal Fusion* / methods
Spinal Stenosis* / surgery