Degenerative Lumbar Stenosis Surgery: Predictive Factors of Clinical Outcome—Experience with 1001 Patients

Aimar, Enrico; Iess, Guglielmo; Gaetani, Paolo; Galbiati, Tommaso Francesco; Isidori, Aldo; Lavanga, Vito; Longhitano, Federico; Menghetti, Claudia; Messina, Alberto Luca; Zekaj, Edvin; Broggi, Giovanni

doi:10.1016/j.wneu.2020.12.048

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…Besides the effect of age, our findings also highlight the powerful impact that a high BMI and high ASA class exert on medical and late surgical complication rates, thus representing the two most influential predictors. In our previous paper, we demonstrated how these two parameters negatively influenced clinical outcome in patients undergoing simple decompressive surgery for spinal stenosis [ 1 ]. Our findings in this paper confirm how these two fundamental parameters should be routinely integrated in the process of selection of candidates for lumbar surgery.…”

Section: Discussionmentioning

confidence: 99%

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

et al. 2022

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Purpose Degenerative spondylolisthesis (DS) is a debilitating condition that carries a high economic burden. As the global population ages, the number of patients over 80 years old demanding spinal fusion is constantly rising. Therefore, neurosurgeons often face the important decision as to whether to perform surgery or not in this age group, commonly perceived at high risk for complications. Methods Six hundred seventy-eight elder patients, who underwent posterolateral lumbar fusion for DS (performed in three different centers) from 2012 to 2020, were screened for medical, early and late surgical complications and for the presence of potential preoperative risk factors. Patients were divided in three categories based on their age: (1) 60–69 years, (2) 70–79 years, (3) 80 and over. Multiple logistic regression was used to determine the predictive power of age and of other risk factors (i.e., ASA score; BMI; sex; presence or absence of insulin-dependent and -independent diabetes, use of anticoagulants, use of antiaggregants and osteoporosis) for the development of postoperative complications. Results In univariate analysis, age was significantly and positively correlated with medical complications. However, when controls for other risk factors were added in the regressions, age never reached significance, with the only noticeable exception of cerebrovascular accidents. ASA score and BMI were the two risk factors that significantly correlated with the higher numbers of complication rates (especially medical). Conclusion Patients of different age but with comparable preoperative risk factors share similar postoperative morbidity rates. When considering octogenarians for lumbar arthrodesis, the importance of biological age overrides that of chronological.

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Section: Discussionmentioning

confidence: 99%

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

et al. 2022

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“…Unlike other reports found in the literature on LIF and posterolateral fusion, which identified significant associations between certain preoperative risk factors such as higher BMI and older age with worse clinical outcomes, none of the preoperative variables (Age, ASA, BMI, gender, and surgical indication) appeared to be significant predictors. 15 , 16 , 17 However, it is noteworthy that ASA approached significance.…”

Section: Discussionmentioning

confidence: 90%

Articular arthrodesis with the facet wedge technique for the treatment of unstable lumbar degenerative disease and associated conditions: A retrospective study of 96 patients

Iess,

Levi,

Della Valle

et al. 2024

World Neurosurgery: X

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“…[ 12 ] Even in the elderly population group, some authors have identified that both developmental canal stenosis and degenerative spinal changes take part in the ultimate generation of the symptom complex of LCS. [ 20 21 ] We identified trauma to the back as possible initiating factor in 24 patients (48%) in Group A and 6 patients (9%) in Group B. Pain as a symptom was significantly more severe in Group A than in Group B patients.…”

Section: Discussionmentioning

confidence: 97%

Lumbar canal stenosis in “young” - How does it differ from that in “old” - An analysis of 116 surgically treated cases

Goel

Bhambere

Shah

et al. 2021

J Craniovert Jun Spine

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Objective: Patients treated for lumbar canal stenosis (LCS) were retrospectively analyzed to evaluate the differences in clinical management in those below (Group A) and those above (Group B) the age of 50 years. All patients were treated with the premise that instability is the nodal point of the pathogenesis of LCS and “only-stabilization” is the surgical treatment. Materials and Methods: During the period June 2014 to June 2020, 116 cases were diagnosed to have LCS and surgically treated by the Goel modification of Camille's transarticular screw fixation technique. Results: Twenty-four patients in Group A and six patients in Group B had a history of “significant” injury to the back at the onset of clinical symptoms. The indices suggested that the intensity of symptoms was relatively more severe in Group A than in Group B. Unilateral leg symptoms were more common in Group A (68%) than in Group B (31.8%). Neurological motor deficits were more common in Group A (28%) than in Group B (12%) patients. Spinal segments surgically treated in Group A ranged from 1 to 4 (average 2 levels) and in Group B it ranged from 2 to 5 (average 3 levels). During the follow-up period that ranged from 6 to 72 months (average 37 months), 100% of patients had varying degrees of relief from symptoms. Conclusions: LCS is confined to a lesser number of spinal segments in the Group A patients. The symptoms were radicular in nature and relatively severe in Group A than in Group B patients.

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Degenerative Lumbar Stenosis Surgery: Predictive Factors of Clinical Outcome—Experience with 1001 Patients

Cited by 7 publications

References 48 publications

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases

Articular arthrodesis with the facet wedge technique for the treatment of unstable lumbar degenerative disease and associated conditions: A retrospective study of 96 patients

Lumbar canal stenosis in “young” - How does it differ from that in “old” - An analysis of 116 surgically treated cases

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