Authors: Ilyas S Aleem Y Raja Rampersaud
Publish Date: 2013/12/04
Volume: 472, Issue: 6, Pages: 1824-1830
Abstract
We compared groups of patients younger and older than 70 years with relative clinical and surgical homogeneity to determine differences in 1 interval improvement in Oswestry Disability Index ODI at 6 weeks 6 months and 12 months postoperatively and 2 perioperative adverse eventsWe performed a subgroup analysis of an ongoing prospective observational study Patients were divided based primarily on age younger than 70 years n = 68 and 70 years or older n = 41 and secondarily on procedure minimally invasive decompression alone or decompression and instrumented fusion With the exception of age and American Society of Anesthesiologists status the two age groups were similar p 03 in baseline demographics and ODI Mean pre and postoperative ODI were compared between groups at 6 weeks 6 months and 12 months Perioperative adverse events were also comparedAt all time intervals both younger and older patients demonstrated p = 005 to 0001 improvements in ODI At the 1year mark no differences in ODI were demonstrated between the younger and older patients for decompression only 21 versus 26 p = 029 or decompression and fusion 19 versus 18 p = 097 Interval improvement in ODI was not different between younger and older patients at any time point for decompression only 6 weeks −18 versus −20 p = 066 6 months −21 versus −17 p = 041 12 months −21 versus −15 p = 029 or decompression and fusion 6 weeks −11 versus −12 p = 058 6 months −21 versus −22 p = 069 12 months −23 versus −27 p = 097 There were no differences in perioperative adverse events between groups p = 067When clinical and surgical heterogeneity is minimized improvements in terms of disability as measured by the ODI and the frequency of adverse events after surgery in elderly patients with lumbar spinal stenosis are comparable to those of younger patients For patients with focal lumbar spinal stenosis age alone should not dissuade us from considering surgical intervention if otherwise indicatedOne of the authors YRR certifies that he or she or a member of his or her immediate family has received or may receive payments or benefits during the study period an amount of USD 10000 to 100000 from Medtronic Memphis TN USA Funding for this project was received from the Toronto General and Western Hospital Foundation Minimal Access Ambulatory Spine Surgery Research and Education Program Toronto Ontario CanadaClinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment drug or device Readers are encouraged to always seek additional information including FDA approval status of any drug or device before clinical useEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained
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