The perioperative risk factors of postoperative complications after posterior lumbar fusion operation: a retrospective analysis of 654 cases

Objective To analyze the perioperative risk factors of postoperative complications after posterior lumbar fusion operation. Methods The clinical data of 654 patients with posterior lumbar fusion during 2010 and 2014 were retrospectively analyzed. Using χ2 test and one-way ANOVA, the predicted risk factors were screened for further Logistic regression. Results The total complication rate was 11.6% among all 654 patients. The major complications included cardiac infarction, deep infection, sepsis, neurological impairment, and secondary operation. And the minor complications included wound dehiscence, urinary tract infection, pulmonary infection, gastrointestinal bleeding, CSF leakage and others. According to χ2 test and one-way ANOVA, renal function insufficiency, preoperative neurological injury, ASA higher than III level, intraoperative blood loss, long operation length, and usage of autogenous bone were screened as risk factors of complications. Renal function insufficiency, preoperative neurological injury, intraoperative blood loss, and long operation length were screened as risk factors of minor complications. And male, renal function insufficiency, preoperative neurological injury, intervertebral fusion, and posteriolateral fusion were screened as risk factors of major complications. However, according to Logistic regression, the independent risk factor of complications were preoperative neurological injury and long operation length; independent risk factors of minor complications were renal function insufficiency, preoperative neurological injury and long operation length; and independent risk factor of major complications was preoperative neurological injury. Conclusion Preoperative neurological injury, renal function insufficiency and long operation length are proved to be the risk factors of postoperative complication in lumbar fusion surgery. Key words: Lumbar vertebrae; Spinal fusion; Postoperative complications; Risk factors