Perioperative renal function in patients over 80 years of age undergoing lumbar interbody fusion. -comparison between groups aged 80 years and over and 60-79 years

Abstract

Introduction: Perioperative acute kidney injury (AKI) can have serious outcomes, including postoperative wound infection, conversion to chronic renal failure, or even death. In the present study, patients aged ≥ 60 years who underwent lumbar single interbody fusion alone at our hospital were divided into two groups: those aged ≥ 80 years, and those aged 60-79 years. We then investigated whether the invasiveness of single lumbar interbody fusion was associated with perioperative renal function in these age groups.

Materials: A total of 77 patients who underwent lumbar single posterior lumbar intervertebral body fusion at L4/5 or L5/S level due to back pain, lower limb pain, and numbness were divided into those aged ≥ 80 years (n=x) and those aged 60-79 years (n=y). Serum total protein (TP), hemoglobin (Hb), creatinine phosphokinase (CPK), creatinine (CRE), and estimated glomerular filtration rate (eGFR) were evaluated preoperatively, the day after surgery, and 7 days after surgery. The rate of change in these parameters was investigated and compared between the two age groups for the presence of rhabdomyolysis associated with surgical invasion and AKI.

Results: Rhabdomyolysis was observed in two patients aged 60-79 years, but in none of those aged ≥ 80 years. Seven days after surgery, there were no cases with worsened renal function in the ≥ 80-year age group, but three cases in the 60-79-year age group. No cases of AKI occurred in either group.

Conclusions: Posterior lumbar interbody fusion can be performed relatively safely with regard to renal function, even in patients aged ≥ 80 years.