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Research ArticleLumbar Spine

Incidence of Respiratory Complications Following Lumbar Spine Surgery

Rajan Murgai, Anthony D'oro, Patrick Heindel, Kyle Schoell, Kaku Barkoh, Zorica Buser and Jeffrey C. Wang
International Journal of Spine Surgery December 2018, 5090; DOI: https://doi.org/10.14444/5090
Rajan Murgai
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
BS
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Anthony D'oro
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
BA
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Patrick Heindel
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
MD
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Kyle Schoell
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
MD
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Kaku Barkoh
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
MD
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Zorica Buser
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
PHD
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Jeffrey C. Wang
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles
MD
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ABSTRACT

Background The purpose of this study is to assess the incidence, risk factors for, and types of respiratory complications occurring in patients undergoing lumbar spine surgery.

Methods Patients undergoing various lumbar spine surgeries from 2007 to 2014 were identified using the PearlDiver patient record database from the nationwide insurance provider Humana Inc. Patient records were analyzed using International Classification of Diseases, Ninth Revision codes and Current Procedural Terminology codes to determine the incidence of pneumonia, pleural effusion, pulmonary collapse, and acute respiratory failure for each procedure type. The incidence of these complications in patients with the risk factors diabetes mellitus, chronic obstructive pulmonary disease (COPD), and smoking was also examined.

Results A total of 64,891 patients (33,280 females; 31,611 males) within the Humana database underwent various lumbar procedures from 2007 to 2014. The overall incidence of respiratory complications in patients undergoing lumbar procedures was 5.7% (n = 3694) within 1 month of having the procedure. Pulmonary collapse was the most common complication with an incidence of 4.3% (n = 2792), followed by pneumonia 1.98% (n = 1285), acute respiratory failure 1.97% (n = 1279), and pleural effusion 1.6% (n = 1048). For each respiratory complication studied, single level discectomy had the lowest complication rate and multilevel anterior lumbar interbody fusion had the highest complication rate. The incidence of each individual respiratory complication was higher in patients who had a history of smoking, COPD, or diabetes mellitus than it was in patients with none of these 3 risk factors (P < .01).

Conclusion The results of this study show that patients who have a history of smoking, COPD, or diabetes mellitus are at a greater risk for respiratory complications following lumbar spine surgery. These findings are useful for patient selection, clinical decision-making, and preoperative counseling.

  • respiratory complications
  • lumbar spine surgery
  • chronic obstructive pulmonary disease
  • diabetes mellitus
  • postoperative complications
  • smoking
  • pulmonary complications

Footnotes

  • Disclosures and COI: There are no conflicts of interest for the current study. Disclosures outside of submitted work: ZB: consultancy: Xenco Medical, AO Spine; research support: SeaSpine (paid directly to institution). JCW: royalties: Biomet, Seaspine, Amedica, Synthes; investments/options: Fziomed, Nexgen, Vertiflex, Electrocore, Surgitech, Expanding Orthopedics, Osprey, Bone Biologics, Pearldiver; Board of Directors: North American Spine Society, North American Spine Foundation, AO Foundation, Cervical Spine Research Society; Editorial Boards: Spine, JAAOS, The Spine Journal, Clinical Spine Surgery, Global Spine Journal; fellowship funding (paid to institution): AO Foundation.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Incidence of Respiratory Complications Following Lumbar Spine Surgery
Rajan Murgai, Anthony D'oro, Patrick Heindel, Kyle Schoell, Kaku Barkoh, Zorica Buser, Jeffrey C. Wang
International Journal of Spine Surgery Dec 2018, 5090; DOI: 10.14444/5090

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Incidence of Respiratory Complications Following Lumbar Spine Surgery
Rajan Murgai, Anthony D'oro, Patrick Heindel, Kyle Schoell, Kaku Barkoh, Zorica Buser, Jeffrey C. Wang
International Journal of Spine Surgery Dec 2018, 5090; DOI: 10.14444/5090
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Keywords

  • respiratory complications
  • lumbar spine surgery
  • chronic obstructive pulmonary disease
  • diabetes mellitus
  • postoperative complications
  • smoking
  • pulmonary complications

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