Artikel
Patient-rated outcomes of lumbar fusion in patients with degenerative disease of the lumbar spine: does age matter?
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Veröffentlicht: | 24. April 2015 |
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Gliederung
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Introduction: The aim of this study was to assess the patient-rated outcome and complication rates associated with lumbar fusion procedures in three different age groups. There is a general reluctance to consider spinal fusion procedures in elderly patients due to the increased likelihood of complications.
Material and methods: Before and at 3 and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI); at the 3- and 12-month follow-ups they also rated the Global Treatment Outcome (GTO) and their satisfaction with care. Patients were divided into three age groups: younger (≥50y <65y; n = 317), older (≥65y <80y; n = 350), and geriatric (≥ 80y; n = 40).
Results: 707 consecutive patients were included. The preoperative comorbidity status differed significantly (p<0.0001) between the age groups, with the highest scores in the geriatric group. Medical complications during surgery were lower in the younger age group (7%) than in the older (13.4%; p=0.006) and geriatric groups (17.5%; p=0.007); surgical complications tended to be higher in the elderly group (younger, 6.3%; older, 6.0 %; geriatric, 15.0%; p=0.09). There were no significant group differences (p>0.05) for the scores on any of the COMI domains, GTO, or patient-rated satisfaction at either 3 or 12 months’ follow-up.
Conclusion: Despite greater comorbidity and complication rates in geriatric patients, the patient-rated outcome was as good in the elderly as it was in younger age groups. These data suggest that geriatric age per se is not a contraindication to instrumented fusion for lumbar degenerative disease.