Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

J Am Geriatr Soc. 2016 Oct;64(10):2011-2018. doi: 10.1111/jgs.14311. Epub 2016 Sep 9.

Abstract

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.

Keywords: neurosurgical procedures; quality of life; self-reported outcomes; spinal stenosis; spondylosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Back Pain / diagnosis
  • Back Pain / epidemiology
  • Back Pain / etiology
  • Decompression, Surgical* / adverse effects
  • Decompression, Surgical* / methods
  • Decompression, Surgical* / statistics & numerical data
  • Disability Evaluation
  • Female
  • Humans
  • Laminectomy* / adverse effects
  • Laminectomy* / methods
  • Laminectomy* / statistics & numerical data
  • Lumbar Vertebrae / pathology*
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / epidemiology
  • Pain, Postoperative* / psychology
  • Prospective Studies
  • Quality of Life*
  • Registries
  • Spinal Stenosis* / diagnosis
  • Spinal Stenosis* / epidemiology
  • Spinal Stenosis* / surgery
  • Treatment Outcome