Purpose of the study: The main objective of this prospective observational study of a consecutive series of patients was to determine the rate of per- and postoperative complications of surgical treatment of lumbar spinal stenosis. A second objective was to describe these complications and search for factors favoring their occurrence.
Material and methods: All patients who underwent surgical treatment of spinal stenosis without significant spinal deviation in our unit between January 1998 and January 2000 were enrolled in this study. The series thus included 306 patients with at least six months follow-up. Three types of data were recorded before surgery: demographic data including comorbidity, data related to the type of stenosis operated, and data related to the type of procedure (simple release, release with fusion, etc.). A special observation chart was designed to record all complications during the hospital stay and follow-up visits at three, six and twelve months. Four categories of complications were recorded: general complications, early or late infections, early or late mechanical disorders, and neurological complications including meningeal involvement and surgery-related neurological disorders. Univariate analysis was performed to determine the overall rate of complications and the incidence within each category of complications. Multivariate analysis using logistic regression was performed to examine factors favoring occurrence of complications.
Results: The overall rate of complications was 26.5%. The incidence of general, infectious, neurological, and mechanical complications was 13, 4.5, 2.6 and 2% respectively. The incidence of serious complications and/or events requiring reoperation was 12%. Comorbidity, body mass index, operative time, and reoperation were found to favor the occurrence of complications.
Discussion and conclusion: The rates of complications reported in the literature have varied greatly. Most have been calculated from retrospective series, making it difficult to compare them with our results. Our work emphasizes the importance of certain favoring factors which should be re-examined in a larger series.