Tomohiro Hikata1, Ken Ishii2, Morio Matsumoto3, Kazuyoshi Kobayashi4, Shiro Imagama4, Kei Ando4, Naoki Ishiguro4, Masaomi Yamashita5, Shoji Seki6, Hidetomi Terai7, Akinobu Suzuki7, Koji Tamai7, Masaaki Aramomi8, Tetsuhiro Ishikawa8, Atsushi Kimura9, Hirokazu Inoue9, Gen Inoue10, Masayuki Miyagi10, Wataru Saito10, Kei Yamada11, Michio Hongo12, Kenji Endo13, Hidekazu Suzuki13, Atsushi Nakano14, Kazuyuki Watanabe15, Junichi Ohya16, Hirotaka Chikuda16, Yasuchika Aoki17, Masayuki Shimizu18, Toshimasa Futatsugi18, Keijiro Mukaiyama18, Masaichi Hasegawa19, Katsuhito Kiyasu20, Haku Iizuka21, Ryoichi Kobayashi21, Yoichi Iizuka22, Kotaro Nishida23, Kenichiro Kakutani23, Hideaki Nakajima24, Hideki Murakami25, Satoru Demura25, Satoshi Kato25, Katsuhito Yoshioka25, Takashi Namikawa26, Kei Watanabe27,28, Kazuyoshi Nakanishi29, Yukihiro Nakagawa30, Mitsunori Yoshimoto31, Hiroyasu Fujiwara32, Norihiro Nishida33, Yasuaki Imajo33, Masashi Yamazaki34, Tetsuya Abe34, Kengo Fujii34, Takashi Kaito35, Yawara Eguchi36, Takeo Furuya36, Sumihisa Orita36, Seiji Ohtori36. 1. Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital. 2. Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital. 3. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo. 4. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Aichi. 5. Department of Orthopaedic Surgery, Japan Community Health Care Organization Funabashi Central Hospital, Chiba. 6. Department of Orthopaedic Surgery, University of Toyama, Toyama. 7. Department of Orthopaedic Surgery, Osaka City University, Osaka. 8. Department of Orthopaedic Surgery, Sanmu Medical Center, Chiba. 9. Department of Orthopaedic Surgery, Jichi Medical University, Tochigi. 10. Department of Orthopaedic Surgery, Kitasato University, Kanagawa. 11. Department of Orthopaedic Surgery, Kurume University, Fukuoka. 12. Department of Orthopaedic Surgery, Akita University, Akita. 13. Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo. 14. Department of Orthopaedic Surgery, Osaka Medical College, Osaka. 15. Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima. 16. Department of Orthopaedic Surgery, The University of Tokyo, Tokyo. 17. Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba. 18. Department of Orthopaedic Surgery, Shinshu University, Nagano. 19. Department of Orthopaedic Surgery, Kyorin University, Tokyo. 20. Department of Orthopaedic Surgery, Kochi University, Kochi. 21. Department of Orthopedic Surgery, Isesaki Municipal Hospital. 22. Department of Orthopaedic Surgery, Gunma University, Gunma. 23. Department of Orthopaedic Surgery, Kobe University, Hyogo. 24. Department of Orthopaedic Surgery, Fukui University, Fukui. 25. Department of Orthopaedic Surgery, Kanazawa University, Ishikawa. 26. Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka. 27. Department of Orthopaedic Surgery, Niigata University. 28. Department of Orthopaedic Surgery, Sado General Hospital, Niigata. 29. Department of Orthopaedic Surgery, Hiroshima University, Hiroshima. 30. Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, Wakayama. 31. Department of Orthopaedic Surgery, Sapporo Medical University, Hokkaido. 32. Department of Orthopaedic Surgery, Osaka-Minami Medical Center, Osaka. 33. Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi. 34. Department of Orthopaedic Surgery, University of Tsukuba, Ibaraki. 35. Department of Orthopaedic Surgery, Osaka University Graduate School, Osaka. 36. Department of Orthopaedic Surgery, Chiba University, Chiba, Japan.
Abstract
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To clarify the poor patient satisfaction after lumbar spinal surgery in elderly patients. SUMMARY OF BACKGROUND DATA: As the global population continues to age, it is important to consider the surgical outcome and patient satisfaction in the elderly. No studies have assessed patient satisfaction in elderly patients undergoing surgical treatment and risk factors for poor satisfaction in elderly patients after lumbar spinal surgery. MATERIALS AND METHODS: A retrospective multicenter survey was performed in 169 patients aged above 80 years who underwent lumbar spinal surgery. Patients were followed up for at least 1 year after surgery. We assessed patient satisfaction from the results of surgery by using a newly developed patient questionnaire. Patients were assessed by demographic data, surgical procedures, complications, reoperation rate, pain improvement, and risk factors for poor patient satisfaction with surgery for lumbar spinal disease. RESULTS: In total, 131 patients (77.5%, G-group) were satisfied and 38 patients (22.5%, P-group) were dissatisfied with surgery. The 2 groups did not differ significantly in baseline characteristics and surgical data. Postoperative visual analog scale score for low back pain and leg pain were significantly higher in the P-group than in the G-group (low back pain: G-group, 1.7±1.9 vs. P-group, 5.2±2.5, P<0.001; leg pain: G-group, 1.4±2.0 vs. P-group, 5.5±2.6, P<0.001). Multivariate regression analysis revealed that postoperative vertebral fracture (P=0.049; odds ratio, 3.096; 95% confidence interval, 1.004-9.547) and reoperation (P=0.025; odds ratio, 5.692; 95% confidence interval, 1.250-25.913) were significantly associated with the patient satisfaction after lumbar spinal surgery. CONCLUSIONS: Postoperative vertebral fracture and reoperation were found to be risk factors for poor patient satisfaction after lumbar spinal surgery in elderly patients, which suggests a need for careful treatment of osteoporosis in addition to careful determination of surgical indication and procedure in elderly patients. LEVEL OF EVIDENCE: Level III.
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To clarify the poor patient satisfaction after lumbar spinal surgery in elderly patients. SUMMARY OF BACKGROUND DATA: As the global population continues to age, it is important to consider the surgical outcome and patient satisfaction in the elderly. No studies have assessed patient satisfaction in elderly patients undergoing surgical treatment and risk factors for poor satisfaction in elderly patients after lumbar spinal surgery. MATERIALS AND METHODS: A retrospective multicenter survey was performed in 169 patients aged above 80 years who underwent lumbar spinal surgery. Patients were followed up for at least 1 year after surgery. We assessed patient satisfaction from the results of surgery by using a newly developed patient questionnaire. Patients were assessed by demographic data, surgical procedures, complications, reoperation rate, pain improvement, and risk factors for poor patient satisfaction with surgery for lumbar spinal disease. RESULTS: In total, 131 patients (77.5%, G-group) were satisfied and 38 patients (22.5%, P-group) were dissatisfied with surgery. The 2 groups did not differ significantly in baseline characteristics and surgical data. Postoperative visual analog scale score for low back pain and leg pain were significantly higher in the P-group than in the G-group (low back pain: G-group, 1.7±1.9 vs. P-group, 5.2±2.5, P<0.001; leg pain: G-group, 1.4±2.0 vs. P-group, 5.5±2.6, P<0.001). Multivariate regression analysis revealed that postoperative vertebral fracture (P=0.049; odds ratio, 3.096; 95% confidence interval, 1.004-9.547) and reoperation (P=0.025; odds ratio, 5.692; 95% confidence interval, 1.250-25.913) were significantly associated with the patient satisfaction after lumbar spinal surgery. CONCLUSIONS:Postoperative vertebral fracture and reoperation were found to be risk factors for poor patient satisfaction after lumbar spinal surgery in elderly patients, which suggests a need for careful treatment of osteoporosis in addition to careful determination of surgical indication and procedure in elderly patients. LEVEL OF EVIDENCE: Level III.