Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study. Issue 10 (9th September 2016) - Giannadakis, Charalampis
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.