What Are Risk Factors for an Ileus After Posterior Spine Surgery?-A Case Control Study.

Publication Title

Global Spine J

Authors

Emre Yilmaz, Swedish Medical Center, Swedish Neuroscience InstituteFollow
Eric Benca, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USAFollow
Akil P Patel, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Sarah Hopkins, Swedish Neuroscience Institute, Seattle, WA, USA.Follow
Ronen Blecher, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Amir Abdul-Jabbar, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Thomas M O'Lynnger, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Rod J Oskouian, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
Daniel C Norvell
Jens R Chapman, Swedish Neuroscience InstituteFollow

Document Type

Article

Publication Date

1-12-2021

Keywords

washington; seattle; swedish neuro

Abstract

STUDY DESIGN: Case-Control Study.

OBJECTIVE: The purpose of this retrospective study is to evaluate risk factors for developing a postoperative ileus after posterior spine surgery.

METHODS: Patient charts, including radiographs were evaluated retrospectively. Diagnosis of an ileus was confirmed radiographically by a CT scan in all cases. The control group was retrieved by selecting a random sample of patients undergoing posterior spine surgery who did not develop bowel dysfunction postoperatively.

RESULTS: A total of 40 patients had a postoperative ileus. The control group consisted of 80 patients. Both groups did not differ significantly in age, gender, BMI, tobacco use, comorbidities or status of previous abdominal surgery. Significant differences between the 2 groups was the length of stay (5.9 vs. 11.2; p = 0.001), surgery in the lumbar spine (47.5% vs. 87.5%; p < 0.001) and major spine surgery involving > 3 levels (35.0% vs. 57.5%; p = 0.019). Patients who suffered from an ileus were more likely to be treated in ICU (23.8% vs. 37.5%; p = 0.115), being re-admitted (0.0% vs 5.0%; p = 0.044) and having a delayed discharge (32.5% vs. 57.5%; p = 0.009). Multivariable analysis demonstrated that lumbar spine surgery compared to thoracic and/or cervical spine surgery (p = 0.00, OR 8.7 CI 2.9-25.4) and major spine surgery involving > 3 levels (p = 0.012; OR 3.0, CI 1.3-7.2) are associated with developing an ileus postoperatively.

CONCLUSION: Surgeries of the lumbar spine as well as those involving > 3 levels are associated with developing a postoperative ileus. Further studies are needed to expand on possible risk factors and to better understand the mechanism underlying postoperative ileus in spine surgery patients.

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences