Charalampis Giannadakis1,2, Ole Solheim3,4,5, Asgeir S Jakola3,6, Trond Nordseth7,8, Agnete M Gulati4,9, Ulf S Nerland3,4, Øystein P Nygaard3,4,10,11, Tore K Solberg11,12, Sasha Gulati3,4,10,13. 1. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. charalampis.giannadakis@ntnu.no. 2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. charalampis.giannadakis@ntnu.no. 3. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. 4. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. 5. National Competence Center for Ultrasound and Image Guided Therapy, St. Olavs University Hospital, Trondheim, Norway. 6. Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 7. Department of Anesthesia, St. Olavs University Hospital, Trondheim, Norway. 8. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. 9. Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway. 10. National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway. 11. Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway, Tromsø, Norway. 12. Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway. 13. Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway.
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.
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.
Authors: David B Anderson; Manuela L Ferreira; Ian A Harris; Gavin A Davis; Ralph Stanford; David Beard; Qiang Li; Stephen Jan; Ralph J Mobbs; Christopher G Maher; Renata Yong; Tara Zammit; Jane Latimer; Rachelle Buchbinder Journal: BMJ Open Date: 2019-02-13 Impact factor: 2.692
Authors: Stephanie T Kha; Haariss Ilyas; Joseph E Tanenbaum; Edward C Benzel; Michael P Steinmetz; Thomas E Mroz Journal: Global Spine J Date: 2018-03-18