Patient Comorbidities, Their Influence on Lumbar Spinal Fusion Surgery, and Recommendations to Reduce Unfavorable Outcomes.

J Am Acad Orthop Surg · Dec 15 2024 · Review

Butrico C, Meisel HJ, Sage K

From the Kuros Biosciences, Bilthoven, The Netherlands (Butrico and Sage), Germany (Meisel)

Spine

SUMMARY — THE REDUCTIONThis review examines how multiple medical comorbidities increase complication and mortality risk after lumbar fusion surgery and offers strategies for optimizing patients perioperatively to improve outcomes.
Abstract, as published

Improvements in healthcare management have led to a decrease in perioperative and postoperative complications. However, perioperative medical complications and mortality rates continue to increase in patients undergoing elective spinal surgeries. This trend is driven by the increase in the older population and the rise in the number of patients with more than two comorbidities. Managing patients with multiple comorbidities requires additional resources, augmenting the financial and societal burden. Despite the high risk of complications and mortality, patients with multiple comorbidities undergo spinal surgery for degenerative spinal conditions daily. These findings highlight the need for heightened awareness, patient education, and management of comorbidities before elective spinal surgeries. This article comprehensively reviews literature on the effects of medical comorbidities on spinal fusion surgery outcomes to increase awareness of the surgical complications associated with comorbidities. In addition, suggested preoperative and postoperative comorbidity management strategies are outlined.

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