Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Arinzon, Zeev; Adunsky, Abraham; Fidelman, Zeev; Gepstein, Reuven

doi:10.1007/s00586-003-0643-7

Cited by 92 publications

(75 citation statements)

References 17 publications

(13 reference statements)

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“…This contrasts results of previous studies reporting on association between these diseases and poor surgical outcome of spinal stenosis. 24,25 The present study has several limitations resulting from its relatively small number of participants, and those limitations related to its retrospective design, such as those related to data collection and outcome variable. In particular, the long-term span of patient enrollment may result in some differences in expectations and satisfaction rates, as well as a possible bias of consistency on the type of information that the participants may have retrieved preoperatively.…”

Section: Discussionmentioning

confidence: 98%

Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and postoperative satisfaction

et al. 2005

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Study design: Retrospective cohort examination. Objectives: Data on expectations and satisfaction rates in elderly patients operated for lumbar spinal stenosis (LSS) are limited. The present study aimed to investigate these issues as well as the factors that might affect them. Setting: A university affiliated hospital. Patients and methods: A follow-up study of 367 consecutive patients aged 65 years and older (mean age 71.4 years), who underwent surgery for degenerative LSS between 1990 and 2000. Data collection included patients' preoperative expectation, demographic data, body mass index, operative risk, duration of symptoms, clinical presentation and patients' satisfaction on follow-up, pain level, activities of daily living level and walking ability. Data were recorded before operation and on follow-up. Preoperative and follow-up data were analyzed by univariate and multivariable models. Results: The response rate on follow-up was 81% (298 patients). A logistic regression analysis showed that advanced age, male gender and high education level were independently associated with positive expectations, while a great number of covariates were associated with patients' satisfaction. High patients' expectations were positively interrelated with satisfaction (r ¼ 0.332, Po0.001). Conclusions: In the elderly, preoperative expectations reasonably predict their postoperative satisfaction rate. It is suggested that a greater effort should be made to narrow the gaps between expectations and satisfaction, perhaps by providing more accurate preoperative information data regarding the outcomes of planned surgery.

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Section: Discussionmentioning

confidence: 98%

Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and postoperative satisfaction

et al. 2005

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“…Arinzon et al 5 analyzed the surgical management of spinal stenosis in elderly patients in 2 groups. In one group, the patients were between 65 and 74 years of age, and in the other group they were older than 75 years.…”

Section: Clinical Outcomementioning

confidence: 99%

Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions

Drazin

Shirzadi²,

Rosner³

et al. 2011

FOC

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Object The elderly population (age > 60 years) is the fastest-growing age group in the US. Spinal deformity is a major problem affecting the elderly and, therefore, the demand for surgery for spinal deformity is becoming increasingly prevalent in elderly patients. Much of the literature on surgery for adult deformity focuses on patients who are younger than 60 years, and therefore there is limited information about the complications and outcomes of surgery in the elderly population. In this study, the authors undertook a review of the literature on spinal deformity surgery in patients older than 60 years. The authors discuss their analysis with a focus on outcomes, complications, discrepancies between individual studies, and strategies for complication avoidance. Methods A systematic review of the MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: “adult scoliosis surgery” and “adult spine deformity surgery.” Exclusion criteria included patient age younger than 60 years. Data on major Oswestry Disability Index (ODI) scores, visual analog scale (VAS) scores, patient-reported outcomes, and complications were recorded. Results Twenty-two articles were obtained and are included in this review. The mean age was 74.2 years, and the mean follow-up period was 3 years. The mean preoperative ODI was 48.6, and the mean postoperative reduction in ODI was 24.1. The mean preoperative VAS score was 7.7 with a mean postoperative decrease of 5.2. There were 311 reported complications for 815 patients (38%) and 5 deaths for 659 patients (< 1%). Conclusions Elderly patient outcomes were inconsistent in the published studies. Overall, most elderly patients obtained favorable outcomes with low operative mortality following surgery for adult spinal deformity.

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“…The third stenosis paper, by Arinzon et al [1], dealing with treatment of diabetics with stenosis, whilst confirming what many of us felt-that is that results are less good, and unpredictable-showed it was worthwhile. This is the sort of paper that provides useful information to surgeons, for counselling patients whilst obtaining informed consent for operation.…”

Section: Spinal Stenosis Surgerymentioning

confidence: 55%

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review

Mulholland

2005

Eur Spine J

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Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients

Cited by 92 publications

References 17 publications

Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and postoperative satisfaction

Decompression surgery for lumbar spinal stenosis in the elderly: preoperative expectations and postoperative satisfaction

Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review

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