Safety of Combined Anterior and Posterior Fusion in the Elderly Population

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Abstract
Study Design.: Multisurgeon, single-institution retrospective observational cohort. Objectives.: Compare complications and outcomes between patients less than 70 years (P =0.347), smoking status, proportion of revision surgeries, and number of levels fused. Surgical time and estimated blood loss were similar between the two cohorts. Nonhome discharge was significantly more frequent in the older cohort (33% vs. 10%, P =0.001). There was no difference in overall complication rates or at any individual interval: in-hospital, 30-day, 90-day, and 1-year. Conclusions.: In a propensity-matched cohort undergoing anterior-posterior lumbar fusion, elderly patients had similar intraoperative, 30-day, 90-day, and 1-year complications and length of hospitalization, suggesting baseline co-morbidity burden rather than age alone may account for much of the observed excess risk. Age alone should not preclude consideration of circumferential fusion when clinically indicated.

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