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- Title
Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study.
- Authors
Giannadakis, Charalampis; Solheim, Ole; Jakola, Asgeir S.; Nordseth, Trond; Gulati, Agnete M.; Nerland, Ulf S.; Nygaard, Øystein P.; Solberg, Tore K.; Gulati, Sasha
- Abstract
Objectives To compare clinical outcomes after decompressive surgery for central lumbar spinal stenosis ( LSS) in individuals aged 80 and older with those of individuals aged 18-79. Design Prospective data from the Norwegian Registry for Spine Surgery. Setting Multicenter observational study. Participants Individuals with central LSS undergoing surgery at 36 orthopedic or neurosurgical departments (N = 1,503; 1,325 aged <80 (median 66, range 21-79); 178 aged ≥80 (median 82, range 80-95)). Intervention Laminectomy or microdecompression. Measurements Changes in Oswestry Disability Index ( ODI), EuroQol 5D ( EQ-5D), back pain numerical rating scale ( NRS), and leg pain NRS at 1 year. Complications and duration of surgical procedures and hospital stays are reported. Results For all participants, there was a significant improvement in ODI (difference 16.60 points, 95% confidence interval ( CI) = 15.59-17.61, P < .001). There were no differences between age cohorts in mean changes in ODI (0.2, 95% CI = −3.05-3.39, P = .92), EQ-5D (0.02, 95% CI = −0.04-0.09, P = .49), back pain NRS (−0.2, 95% CI = −0.7-0.4, P = .56), or leg pain NRS (−0.1, 95% CI = −0.7-0.5), P = .77). There were no differences in perioperative complications between age cohorts (4.9% vs 7.9%, P = .11). Participants aged 80 and older reported more complications occurring within 3 months (11.8% vs 7.5%, P = .02), mainly because of more urinary tract infections (9.6% vs 3.5%, P = .001). Mean duration of hospital stays was 1.3 days longer for participants aged 80 and (4.5 vs 3.2 days, P < .001). There were no differences in duration of single-level microdecompression ( P = .94), two-level microdecompression ( P = .53), single-level laminectomy ( P = .78), or two-level laminectomy ( P = .08). Conclusion Individuals aged 80 and older experience improvement in self-reported outcomes similar to those of younger individuals after decompressive surgery for LSS.
- Subjects
NORWAY; LUMBAR vertebrae surgery; CHI-squared test; COMPARATIVE studies; CONFIDENCE intervals; LENGTH of stay in hospitals; LAMINECTOMY; LUMBAR vertebrae; MEDICAL cooperation; SCIENTIFIC observation; ORTHOPEDIC surgery; PAIN; PATIENT satisfaction; PROBABILITY theory; RESEARCH; RESEARCH funding; SELF-evaluation; STATISTICS; SURGICAL complications; T-test (Statistics); URINARY tract infections; DATA analysis; MULTIPLE regression analysis; TREATMENT effectiveness; SURGICAL decompression; DATA analysis software; DESCRIPTIVE statistics; MANN Whitney U Test; OLD age
- Publication
Journal of the American Geriatrics Society, 2016, Vol 64, Issue 10, p2011
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.14311