Effectiveness of Surgery for Lumbar Stenosis and Degenerative Spondylolisthesis in the Octogenarian Population

Rihn, Jeffrey A.; Hilibrand, Alan S.; Zhao, Wenyan; Lurie, Jon D.; Vaccaro, Alexander R.; Albert, Todd J.; Weinstein, James Neil

doi:10.2106/jbjs.n.00313

Cited by 101 publications

(89 citation statements)

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“…The goal of conservative treatment is to reduce pain gradually over time; however, surgery is often recommended. The operative treatment for LSS and degenerative spondylolisthesis provides substantial lasting benefit compared with nonoperative care172327). As a result, the number of surgical procedures performed for LSS has increased steadily as the oldest sector of the population continues to grow1416).…”

Section: Introductionmentioning

confidence: 99%

Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis

et al. 2016

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ObjectiveThe risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation.MethodsA retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored.ResultsForty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation.ConclusionModerate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.

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Section: Introductionmentioning

confidence: 99%

Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis

et al. 2016

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“…LSS is the most frequent indication for spinal surgery in elderly adults, and as the oldest segment of the population continues to grow, the prevalence is likely to increase . In individuals aged 80 and older, favorable outcomes after surgery for LSS were reported in 25 participants from an observational study and 58 participants from a subgroup analysis of the Spine Patient Outcomes Research Trial . Still, knowledge about outcomes after surgery for LSS in individuals aged 80 and older is limited.…”

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confidence: 99%

“…[10][11][12] In individuals aged 80 and older, favorable outcomes after surgery for LSS were reported in 25 participants from an observational study 13 and 58 participants from a subgroup analysis of the Spine Patient Outcomes Research Trial. 14 Still, knowledge about outcomes after surgery for LSS in individuals aged 80 and older is limited.…”

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confidence: 99%

Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Giannadakis

Solheim

Jakola

et al. 2016

J American Geriatrics Society

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“…The authors found that operative treatment offered a significant benefit over nonoperative treatment in patients who were at least 80 years of age. There were no significant increases in the complication and mortality rates following a surgical procedure in this patient population compared with younger patients 40 .…”

Section: Degenerative Spondylolisthesismentioning

confidence: 58%