Operative Risk Assessment of Degenerative Spinal Disorder Comparing with Total Hip Replacement

STUDY DESIGN: Retrospective study. OBJECTIVES: To assess the operative risks and complications of posterior decompression and fusion for degenerative spine disorders, we compared single level posterior decompression and posterolateral fusion of lumbar spine with total hip arthroplasty which have been evaluated in many reports and articles on complications and operative risks. SUMMARY OF LITERATURE REVIEW: There has been no study comparing the relative risks of spinal surgery with total hip arthroplasty. MATERIALS AND METHODS: One hundred and thirty-six subjects (mean age 69.6 years) who received single level posterior decompression and posterolateral fusion for degenerative lumbar disorders from February 2000 to May 2010 were selected as group A, and 136 subjects (mean age 67.2 years) who received total hip arthroplasty during the same period were selected as group B. A comparative analysis was performed according to age, gender, pre-operative ASA status based on their underlying medical conditions, total operative time, blood loss, hospitalization period, incidence of major and minor complications and functional recovery at the time of final follow up using retrospective and statistical manners from medical records and radiologic evaluations. RESULTS: The total operative time and blood loss were longer in group A with statistical significance (P<0.01). Major complications were frequent in group B with 16 cases and in group A with 6 cases (P<0.05). There were no significant differences in the total hospitalization period, incidence of minor complications and post-operative functional recovery. CONCLUSIONS: The present study revealed no increased operative risks for surgery for degenerative lumbar disorders compared with total hip arthroplasty in similar age groups.

Comparison of Operative Risks between Claudicants and Critical Limb Ischemic Patients

PURPOSE: To compare the perioperative risks and comorbidities between patients with claudication and patients with critical limb ischemia. METHOD: We retrospectively reviewed the data of 162 patients treated for the leg ischemia at the Vascular Surgery Department at Daegu Catholic University. Excluding patients with acute artery occlusion, vasculitis and Buerger's disease, 127 patients including 58 claudication and 69 critical limb ischemia cases (CI) were studied. To compare perioperative risks, patients data including demographics, physical status classification according to American Society of Anesthesiologists (ASA) and comorbities was collected. RESULT: Mean age was 67.8 years in claudication cases and 68.2 in CI. 98 patients (77.1%) had at least one more associated disease, specifically 87.9% (51/58) in patients with claudication and 66.7% (46/69) in CI. Hypertension was the most frequent disease in both group. Cerebrovascular disease (CVD)(14.5% vs. 12.6%), heart disease (17.3% vs. 10.3%), ASA class 3 (seriously limited physical condition) were more frequent in CI than claudication group (24.6% vs. 15.5%) but not statistically different. 6 patients died during early postoperative period in CI and the claudication group had no deaths. CONCLUSION: Patietns with peripheral arterial diseased patients had high rates of comorbidity (77.1%). More serious disease such as CVD, heart disease were found in CI and associated with higher mortality, which ascertains that more careful attention is be needed, even urgent situations.