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Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis
Published on: February 24, 2023
Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study
Charalampis Giannadakis1,2, Ole Solheim3,4,5, Asgeir S Jakola3,6
1Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. charalampis.giannadakis@ntnu.no.
Objectives:
To compare clinical outcomes after decompressive surgery for central lumbar spinal stenosis (LSS) in individuals aged 80 and older with those of individuals aged 18-79.
Design:
Prospective data from the Norwegian Registry for Spine Surgery.
Setting:
Multicenter observational study.
Participants:
Individuals with central LSS undergoing surgery at 36 orthopedic or neurosurgical departments (N = 1,503; 1,325 aged <80 (median 66, range 21-79); 178 aged ≥80 (median 82, range 80-95)).
Intervention:
Laminectomy or microdecompression.
Measurements:
Changes in Oswestry Disability Index (ODI), EuroQol 5D (EQ-5D), back pain numerical rating scale (NRS), and leg pain NRS at 1 year. Complications and duration of surgical procedures and hospital stays are reported.
Results:
For all participants, there was a significant improvement in ODI (difference 16.60 points, 95% confidence interval (CI) = 15.59-17.61, P < .001). There were no differences between age cohorts in mean changes in ODI (0.2, 95% CI = -3.05-3.39, P = .92), EQ-5D (0.02, 95% CI = -0.04-0.09, P = .49), back pain NRS (-0.2, 95% CI = -0.7-0.4, P = .56), or leg pain NRS (-0.1, 95% CI = -0.7-0.5), P = .77). There were no differences in perioperative complications between age cohorts (4.9% vs 7.9%, P = .11). Participants aged 80 and older reported more complications occurring within 3 months (11.8% vs 7.5%, P = .02), mainly because of more urinary tract infections (9.6% vs 3.5%, P = .001). Mean duration of hospital stays was 1.3 days longer for participants aged 80 and (4.5 vs 3.2 days, P < .001). There were no differences in duration of single-level microdecompression (P = .94), two-level microdecompression (P = .53), single-level laminectomy (P = .78), or two-level laminectomy (P = .08).
Conclusion:
Individuals aged 80 and older experience improvement in self-reported outcomes similar to those of younger individuals after decompressive surgery for LSS.
