Lumbar spine surgery and mortality among Medicare beneficiaries, 1986.

OBJECTIVES: The purpose of this study was to compare lumbar spine surgical procedures by age, gender, and number of comorbidities with respect to mortality in patients 65 years of age and older in the United States. METHODS: A 100% sample of the 1986 Medicare inpatient Health Care Financing Administration claims files databases involving lumbar spine surgical procedures was analyzed. RESULTS: Lumbar spine surgery in 34,418 patients (median age = 71 years) was associated with a significant increase in in-hospital and 1-year cumulative mortality only beyond 80 years of age. When adjusted for age, in-hospital and 1-year cumulative mortality with both decompression and excision procedures were significantly higher in men than in women. When adjusted for both age and gender, mortality increased significantly as the number of comorbidities increased. CONCLUSIONS: With lumbar spine surgery in elderly patients, mortality did not significantly increase until 80 years of age and was consistently associated with decompression and excision, with male gender, and with an increase in number of comorbidities.