Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS...

Area of Science:

• Spine surgery outcomes
• Geriatric orthopedics
• Radiographic analysis

Background:

• Lumbar spinal stenosis is common in the elderly.
• Sagittal balance is increasingly important in spinal surgery.
• The effect of decompression alone on sagittal alignment in elderly patients is not well understood.

Purpose of the Study:

• To investigate the impact of decompression surgery for lumbar spinal stenosis on sagittal alignment in elderly patients.
• To evaluate changes in sagittal alignment post-decompression using the EOS imaging system.
• To identify factors influencing sagittal alignment changes after surgery.

Main Methods:

• Retrospective analysis of 49 elderly patients undergoing decompression surgery for lumbar spinal stenosis.
• Radiologic parameters (including sagittal vertical axis - SVA) and clinical outcomes (Oswestry disability index - ODI, EQ-5D) assessed preoperatively, and at 2 weeks and 1 year postoperatively.
• Multivariate analysis to identify predictors of sagittal alignment changes.

Main Results:

• Significant improvements in sagittal alignment, including increased thoracic kyphosis and decreased SVA, were observed at one year postoperatively.
• Clinical outcomes (ODI and EQ-5D) significantly improved at both 2 weeks and 1 year postoperatively.
• Preoperative SVA and higher ODI were significant predictors of sagittal alignment changes.

Conclusions:

• Decompression surgery for lumbar spinal stenosis effectively improves sagittal alignment and clinical outcomes in elderly patients.
• Decompression alone is a viable option for elderly patients, especially those with preoperative sagittal imbalance and disability.
• EOS imaging system is effective for evaluating sagittal alignment changes.