Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion?
Study Design Retrospective cohort. Purpose This study’s primary objective was to compare the clinico-radiological outcomes and incidence of perioperative complications of transforaminal lumbar interbody fusion (TLIF) at lower lumbar levels for elderly and younger patients. The secondary objective wa...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2021-08-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0084.pdf |
| _version_ | 1819136095469699072 |
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| author | Jwalant Y. Patel Vishal G. Kundnani Bansari Chawada |
| author_facet | Jwalant Y. Patel Vishal G. Kundnani Bansari Chawada |
| author_sort | Jwalant Y. Patel |
| collection | DOAJ |
| description | Study Design Retrospective cohort. Purpose This study’s primary objective was to compare the clinico-radiological outcomes and incidence of perioperative complications of transforaminal lumbar interbody fusion (TLIF) at lower lumbar levels for elderly and younger patients. The secondary objective was to evaluate the effect of age on clinical outcomes and patient satisfaction in the two groups. Overview of Literature The lumbar interbody fusion surgery in elder age has been reported to produce a higher complication rate and suboptimal results. Literature evaluating efficacy and safety of TLIF in elderly population is scanty. The effect of age on clinical outcome and the overall patient satisfaction after TLIF has been understudied. Methods This retrospective study was conducted from 2011 to 2017 with 121 patients, who underwent TLIF and were divided into two cohorts based on age (group A, >65 years and group B, <65 years). Perioperative clinical/radiological parameters, postoperative complications, and satisfactory outcomes were evaluated in both groups. A statistical analysis between two matched groups was performed with logistic regression analysis and Student t-test. Results The mean age was 73.8±4.5 years in group A and 47.3±12.7 years in group B. There was no statistical difference in surgical time (p=0.15), mobilization, or hospital stay (p=0.15) between the two groups. There were no statistically significant differences noted in the Oswestry Disability Index, Visual Analog Scale, or Wang’s outcome score between the two groups at final follow-up. Postoperative complications not affecting outcome were common in the elderly group, but there was no statistically significant difference noted among neurological or cardiopulmonary events between the two groups. Conclusions In judiciously selected patients with proper preoperative risk assessment and optimized medical co-morbidities, TLIF surgery can have successful results, in terms of clinical outcome and satisfaction, in the elderly. Older age should not be a contraindication for TLIF in patients with degenerative lumbar disease. |
| first_indexed | 2024-12-22T10:29:32Z |
| format | Article |
| id | doaj.art-6f11adbfd445464ab56e16221f8743ef |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-22T10:29:32Z |
| publishDate | 2021-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-6f11adbfd445464ab56e16221f8743ef2022-12-21T18:29:23ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462021-08-0115444745410.31616/asj.2020.00841277Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion?Jwalant Y. Patel0Vishal G. Kundnani1Bansari Chawada2 Mumbai Institute of Spine Surgery, Bombay Hospital and Medical Research Centre, Mumbai, India Mumbai Institute of Spine Surgery, Bombay Hospital and Medical Research Centre, Mumbai, India Department of Preventive and Social Medicine, Medical College Baroda, Vadodara, IndiaStudy Design Retrospective cohort. Purpose This study’s primary objective was to compare the clinico-radiological outcomes and incidence of perioperative complications of transforaminal lumbar interbody fusion (TLIF) at lower lumbar levels for elderly and younger patients. The secondary objective was to evaluate the effect of age on clinical outcomes and patient satisfaction in the two groups. Overview of Literature The lumbar interbody fusion surgery in elder age has been reported to produce a higher complication rate and suboptimal results. Literature evaluating efficacy and safety of TLIF in elderly population is scanty. The effect of age on clinical outcome and the overall patient satisfaction after TLIF has been understudied. Methods This retrospective study was conducted from 2011 to 2017 with 121 patients, who underwent TLIF and were divided into two cohorts based on age (group A, >65 years and group B, <65 years). Perioperative clinical/radiological parameters, postoperative complications, and satisfactory outcomes were evaluated in both groups. A statistical analysis between two matched groups was performed with logistic regression analysis and Student t-test. Results The mean age was 73.8±4.5 years in group A and 47.3±12.7 years in group B. There was no statistical difference in surgical time (p=0.15), mobilization, or hospital stay (p=0.15) between the two groups. There were no statistically significant differences noted in the Oswestry Disability Index, Visual Analog Scale, or Wang’s outcome score between the two groups at final follow-up. Postoperative complications not affecting outcome were common in the elderly group, but there was no statistically significant difference noted among neurological or cardiopulmonary events between the two groups. Conclusions In judiciously selected patients with proper preoperative risk assessment and optimized medical co-morbidities, TLIF surgery can have successful results, in terms of clinical outcome and satisfaction, in the elderly. Older age should not be a contraindication for TLIF in patients with degenerative lumbar disease.http://www.asianspinejournal.org/upload/pdf/asj-2020-0084.pdflumbar spine surgerydiscectomylaminectomylumbar fusionperioperativeperioperative complicationspseudoarthrosis |
| spellingShingle | Jwalant Y. Patel Vishal G. Kundnani Bansari Chawada Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? Asian Spine Journal lumbar spine surgery discectomy laminectomy lumbar fusion perioperative perioperative complications pseudoarthrosis |
| title | Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? |
| title_full | Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? |
| title_fullStr | Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? |
| title_full_unstemmed | Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? |
| title_short | Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? |
| title_sort | is older age a contraindication for single level transforaminal lumbar interbody fusion |
| topic | lumbar spine surgery discectomy laminectomy lumbar fusion perioperative perioperative complications pseudoarthrosis |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0084.pdf |
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