Skip to main content
  • Anesthesia Time as a Predictor for Perioperative, Postoperative, and Post-Discharge Outcomes Following Posterior Lumbar Fusion

    Final Number:

    Nir Tomer BS; Sean N Neifert BS; Daniel J Snyder BS; Jared C Tishelman BA; Samuel DeMaria MD; John M. Caridi MD; Jonathan S. Gal MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Posterior lumbar fusion (PLF) is a common procedure performed by orthopedic and neurologic surgeons for a variety of spinal pathologies. Time under anesthesia can be used as a surrogate to determine length and difficulty of surgery. This analysis looked to see if time under anesthesia could be a predictor for poor outcomes. This data can be used to help surgeons map out postoperative care of their patients.

    Methods: PLF cases were queried from a single institution based on the CPT codes 22630, 22633, and 22612. Cases were stratified based on time under anesthesia and separated into quintiles. Chi-square test and multivariable logistic regression were used to compare the shortest anesthesia quintile to all other quintiles for a variety of outcomes. Data were controlled for age, sex, and ASA class. A Bonferroni correction was applied, such that alpha=0.0125 and all confidence intervals were 98.75%.

    Results: 3273 PLF cases were obtained for analysis. Prolonged extubation was only affected by anesthesia time for the top quintile (OR=16.88, CI:6.68-42.66, p<.0001). The 4th (OR=12.81, CI:3.48-47.19, p<.0001) and 5th (OR=59.01, CI:16.53-210.7, p<.0001) quintiles were predictors of required ICU stay. The 2nd (OR=2.14, CI:1.38-3.32, p<.0001), 3rd (OR=2.97, CI:1.95-4.54, p<.0001), 4th (OR=4.55, CI:3.01-6.89, p<.0001), and 5th (OR=10.92, CI:7.27-16.39, p<.0001) quintiles were predictors of in-hospital complications. The 2nd (OR=2.30, CI:1.48-3.58, p<.0001), 3rd (OR=3.08, CI:2.01-4.73, p<.0001), 4th (OR=4.88, CI:3.21-7.42, p<.0001), and 5th (OR=12.97, CI:8.58-19.61, p<.0001) quintiles were predictors of non-home discharge. The 2nd (OR=2.11, CI:1.32-3.37, p<.0001), 3rd (OR=2.23, CI:1.41-3.51, p<.0001), 4th (OR=3.43, CI:2.20-5.37, p<.0001) and 5th (OR=7.50, CI:4.83-11.64, p<.0001) quintiles were predictors of prolonged LOS.

    Conclusions: Results indicate that time under anesthesia significantly affects perioperative and postoperative outcomes in patients who undergo PLF, but it does not play a role in post-discharge outcomes. This warrants further investigation into anesthesia time as a predictor for morbidity.

    Patient Care: This research will help care team members identify potential factors that play a role in morbidity following posterior lumbar fusion. This will also help map out and plan postoperative care in patients who undergo posterior lumbar fusion.

    Learning Objectives: By the conclusion of this session, participants should be able to understand the importance of anesthesia time on episode-based outcomes in patients undergoing PLF.


We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy