# Clinical and Surgical Outcomes in Patients with Lumbar Spine Pathologies: A Retrospective Study

## TL;DR

This study examines outcomes of lumbar spine surgery, finding that early neurological changes are more linked to longer hospital stays than patient health or implant use.

## Contribution

The study identifies early postoperative neurological changes as a key predictor of prolonged hospitalization after lumbar spine surgery.

## Key findings

- Most patients had a short hospital stay (median 3 days) after lumbar spine surgery.
- Early neurological changes were strongly associated with longer hospital stays.
- Unplanned reoperations occurred in 17.6% of cases within 90 days.

## Abstract

Background: Enhanced recovery pathways and modern fixation systems have shortened admission after lumbar spine surgery, yet the interplay between implant choice, comorbidity, and early morbidity remains incompletely defined. Methods: We undertook a retrospective, single-center cohort study of lumbar procedures performed at SANADOR Clinical Hospital (Bucharest, Romania) between 1 January 2023 and 31 May 2024. Eighty-six adult patients (64 women, 22 men; mean age 64.9 ± 10.8 years) met the inclusion criteria. Outcomes included length of stay (LOS), early postoperative neurological change (Frankel/American Spinal Injury Association (ASIA) Impairment Scale), and unplanned reoperation within 90 days. Analyses were performed in Python 3.11 (pandas, SciPy, statsmodels) and verified in IBM SPSS 28.0; α = 0.05. Results: Spondylolisthesis was the predominant diagnosis (60.5%), followed by lumbar stenosis (17.4%). Instrumentation was used in 75 cases (87.2%). Median LOS was 3 days (mean 3.8 ± 2.1), and most patients were discharged by postoperative day 4. LOS did not differ by interbody cage status (Mann–Whitney p = 0.459; median 3 vs. 3 days). Early postoperative neurological change occurred in 34.9% but improved or resolved in all cases by discharge; no permanent motor deficits were observed. Unplanned reoperation within 90 days occurred in 17.6%. In multivariable logistic regression for prolonged hospitalization (LOS > 4 days), early postoperative neurological change was associated with increased odds of prolonged LOS (OR 4.45, 95% CI 1.29–15.43; p = 0.018), whereas age showed only a borderline association (OR 1.06 per year, 95% CI 1.00–1.14; p = 0.065). Conclusions: In this single-center retrospective cohort, postoperative hospitalization was generally short. Prolonged LOS was more closely associated with early postoperative neurological change than with baseline comorbidity or interbody cage use. These findings should be interpreted as short-term, context-specific observations from a complex, predominantly instrumented referral cohort.