Lumbar Fusion in Octogenarians

Abstract

Surgical treatment need not be withheld on the basis of age; elderly patients can successfully be treated using MIS techniques, and are-in our experience-among the most satisfied with their outcomes, enjoying significant improvements in pain, mobility, and quality of life.

Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review

“…At least two studies reported change in hemoglobin, presumably independently measured, but did not separately report patient fluid balance [12,13] . No studies used defined criteria for or an independent or blinded observer to decide the following study parameters: (1) Hospital discharge eligibility (i.e., LOS); (2) Opiate prescription or availability; and (3) Need for perioperative transfusion.…”

“…Identified pertinent studies are shown in Table 1, including three randomized controlled trials (RCTs) (Cho et al [14] , Usman et al [15] and Watanabe et al [16] ), one incompletely randomized trial (Mobbs et al [17] ; randomized by consecutive, odd/even patient order [18] ), and one cohort comparison study [12] . In Table 2 Three studies specifically examined rates of post operative pain in these patient groups.…”

“…Hrabalek et al [27] reported a 0% transfusion use in the MIS XLIF and open ALIF cohorts. Rodgers's 2010 study, focusing on patients 80 years of age and older, reported no use of perioperative transfusion in MIS XLIF patients, but a 70% rate of transfusion in PLIF patients [12] . Regarding non controlled studies, Rodgers et al [13] reported a 0.2% rate of transfusion in XLIF patients, while Berjano et al [34] reported a 1% transfusion rate.…”

“…-0 1 -14% ---Nomura et al [22] [23] 102 ± 44 -35 ± 76 -11% -2.1 2.2 Wada et al [24] 144 -60 -7% --- [27] 2014 XLIF Retrospective cohort, XLIF vs ALIF DDD, FBSS, spondylolisthesis 88 120 Smith et al [28] 2012 XLIF Retrospective cohort, XLIF vs ALIF DDD, LSS, FBSS, spondylolisthesis, herniation 115 87 1 Rodgers et al [12] 2010 XLIF Retrospective cohort, XLIF vs PLIF > 80 yr, LSS, FBSS spondylolisthesis, scoliosis, fracture 40 20 Huang et al [29] 2010 MIS-ALIF 2 Prospective cohort, MIS-ALIF vs ALIF Not defined 10 13 Case series 3 Rodgers et al [13] 2011 XLIF PCS LSS, DDD, FBSS, spondylolisthesis, scoliosis 600 -Ruetten et al [30] 2005 XLIF RCS Lumbar disc prolapse 463 -Lykissas et al [31] 2014 XLIF RCS Degenerative spinal conditions 144 -Grimm et al [32] 2014 XLIF RCS DDD, LSS, FBSS, scoliosis, spondylolisthesis, herniation 108 -Tohmeh et al [33] 2011 XLIF PCS LSS, DDD, spondylolisthesis, spondylosis, scoliosis, recurrent herniation, ASD…”

“…Marchi et al [35] 2012 XLIF PCS Spondylolisthesis 52 -Sharma et al [36] 2011 XLIF RCS Spondylosis ± listhesis, scoliosis 43 -Pimenta et al [25] 2011 XLIF PCS DDD 36 -Ahmadian et al [37] 2013 XLIF RCS L4/L5 spondylolisthesis 31 -Caputo et al [38] 2012 XLIF PCS Scoliosis 30 -Malham et al [39] 2012 XLIF PCS DDD, spondylolisthesis, scoliosis 30 - 4 Pimenta et al [40] 2013 XLIF RCT L4/L5 DDD 30 -Elowitz et al [41] 2011 XLIF PCS LSS 25 -Oliveira et al [42] [27] ----28% 24% --Smith et al [28] 112 ± 31 173 ± 31 90 ± 74 311 ± 370 3% 6% 1.7 ± 1.3 3.6 ± 0.9 Rodgers et al [12] --1.4 g Hb 2.7 g Hb --1.3 5.3 Huang et al [29] 176 ± 8 202 ± 15 572 ± 93 970 ± 209 --11.6 ± 1.3 12.5 ± 1.3 Case series Rodgers et al [13] --1.38 g Hb -1% -1.2 -Ruetten et al [30] …”