Perioperative Results and Complications after Posterior Lumbar Interbody Fusion for Spinal Stenosis in Geriatric Patients over than 70 Years Old

Abstract

ObjectiveAs increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF).MethodsWe retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70–75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed.ResultsGroup A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups.ConclusionIncreasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon’s consideration after careful selection and clinical judgement.

Long-Term Safety and Efficacy of Minimally Invasive Lumbar Decompression Procedure for the Treatment of Lumbar Spinal Stenosis With Neurogenic Claudication

“…18 Spinal fusion studies have reported related complication rates as high as 23.3% through 2 years. 24,25 The rate of device removal at 2-year follow-up has been reported to be 16.3% for a currently marketed IPD device. 22 The rate of lumbar spine fracture has been reported to be 4.2% for fusion procedures 21 and 16.3% for a currently marketed spacer 22 at 2-years.…”

<p>Clinical Comparison of Full-Endoscopic and Microscopic Unilateral Laminotomy for Bilateral Decompression in the Treatment of Elderly Lumbar Spinal stenosis: A Retrospective Study with 12-Month Follow-Up</p>

“…[4][5][6] However, there is much uncertainty in the surgical treatment of LSS, especially the elderly patients with comorbidities. 7,8 The conventional approach for decompression is open laminectomy, which has been proved to be a surgical method with superior outcomes and satisfaction, compared to nonsurgical management. 9,10 However, open decompression laminectomy can damage spinal structures such as paravertebral muscles, bones, and ligaments, resulting in muscle atrophy, low back pain, and postoperative low back syndrome.…”

Feasibility of Full Endoscopic Spine Surgery in Patients Over the Age of 70 Years With Degenerative Lumbar Spine Disease

“…Lumbar degenerative spine disease affects the majority of the population in all societies with variable outcomes in old age. The multiple comorbidities that exist have an important bearing on the outcome of prolonged spine surgery [ 1 - 3 ]. At this age, the physical incapacities and comorbid illness make any intervention in the form of surgery a challenging task.…”

“…At this age, the physical incapacities and comorbid illness make any intervention in the form of surgery a challenging task. The rate of complication after spine surgery may be as high as 35% [ 1 ]. The overall quality of life frequently gets hampered after open spine surgery [ 4 , 5 ], and with increasing longevity nowadays it is all the more a matter of concern.…”