Clinical Results of Lumbar Spinal Fusion in Degenerative Spine Disease in Patients over 75 Years Old: Comparative Study of Patients over 65 Years Old and Patients less than 75 Years Old

Kyu Jung Cho; Seung Rim Park; Myoung Joo Park

doi:10.4055/jkoa.2012.47.5.330

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Cho, Park, and Park: Clinical Results of Lumbar Spinal Fusion in Degenerative Spine Disease in Patients over 75 Years Old: Comparative Study of Patients over 65 Years Old and Patients less than 75 Years Old

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(5): 330-336.

Published online: 30 October 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.5.330

Clinical Results of Lumbar Spinal Fusion in Degenerative Spine Disease in Patients over 75 Years Old: Comparative Study of Patients over 65 Years Old and Patients less than 75 Years Old

Kyu Jung Cho, M.D., Seung Rim Park, M.D., Myoung Joo Park, M.D.

Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.

Correspondence to: Kyu Jung Cho, M.D. Department of Orthopedic Surgery, Inha University School of Medicine, 27, Inhang-ro, Jung-gu, Incheon 400-711, Korea. TEL: +82-32-890-3661, FAX: +82-32-890-3099, chokj@inha.ac.kr

Received 26 January 2012 Revised 19 May 2012 Accepted 6 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The elderly patients have been known for high incidence of postoperative complications following a lumbar fusion surgery. This study was conducted to determine the results of clinical outcomes after a lumbar fusion surgery in patients older than 75 years and to compare with those in patients between 65 and 74 years old.

Materials and Methods

One hundred twenty-five patients who underwent lumbar fusion were enrolled. The mean follow-up was 22.5±15.7 months. Preoperative diagnosis was spinal stenosis in 113 patients and degenerative spondylolisthesis in 12 patients. Revision surgery or multi-level spinal fusion (>4 segments) was excluded. There were 27 patients in group A (>75 years) and 98 patients in group B (65-74 years). Preoperative American Society of Anesthesiologists (ASA) scores, visual analog scale (VAS), Oswestry disability index (ODI), postoperative complications, and bone union rate were compared.

Results

The mean age was 78.6 years and 68.8 years in Group A and Group B, respectively. The mean preoperative ASA score was statistically different between group A and group B (p=0.025). The mean bone mineral density T score in group A was higher than that in group B (p=0.002). The mean VAS did not show a difference between the groups (p=0.171). There was no difference in the mean ODI between the groups in the improvement of VAS and ODI. The major and minor complications of early complications and late complications were observed without any statistical difference.

Conclusion

Although preoperative ASA score was higher and osteoporosis was severe in the elderly patients (>75 years old), the improvement of clinical outcome was satisfactory as much as younger patients (65-74 years old) following a lumbar fusion surgery for degenerative spinal disease.

Keywords: aged, over 75 years old, complication, clinical result, lumbar spinal fusion

Figures and Tables

Table 1

Demographic Data of Groups A and B

Values are presented as mean±standard deviation or number. ^*Number of patient, ^†number of fusion level.

Table 2

Preoperative Comorbidity of Groups A and B

Values are presented as number. ^*Number of patient, ^†number of case.

COPD, chronic obstructive pulmonary disease.

Table 3

Postoperative Complications of Groups A and B

Values are presented as number. ^*Number of patient, ^†number of case.

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