Effects of age on the perioperative characteristics and short-term outcome of posterior lumbar fusion surgery.
OBJECTIVE
Although advances in patient care have enabled surgeons to perform posterior lumbar decompression and fusion (PLDF), increased age remains a major concern when designing a treatment strategy. The authors conducted a study to evaluate if increased age has any effect on lumbar fusion surgery in terms of perioperative events.


METHODS
This retrospective study comprised 129 patients (age range 25-91 years) with spondylolisthesis, lumbar stenosis and/or disc degeneration/herniation with instability, or unsuccessful results after a failed previous PLDF. The patients were stratified by age: those younger than 65 years of age (85 patients) and those at least 65 years of age (44 patients). The parameters reviewed included comorbid conditions, American Society of Anesthesiologists score, instrumentation technique (pedicle screws, a combination of pedicle screw fixation [PSF] and posterior lumbar interbody fusion [PLIF], or noninstrumented fusions), number of fused levels, operative time, estimated blood loss (EBL), complications, and hospital length of stay (LOS). Fusion strategies in the elderly tended to be more conservative. Repeated operations and PSF/PLIF procedures were less frequent in the older age group. Older age did not result in increased complications, EBL, and operative time. Longer hospital LOS was observed in the older age group (7 +/- 3.5 days) compared with the younger age group (5.5 +/- 1.9 days) (p = 0.022).


CONCLUSIONS
Complications and perioperative events following PLDF in the elderly are comparable with those observed in younger patients. Withholding lumbar spine fusion solely based on advanced age is not warranted.
Kilinçer
Cumhur
C
Department of Neurosurgery, Trakya University Medical Faculty, Edirne, Turkey. ckilincer@trakya.edu.tr
Steinmetz
Michael P
MP
Sohn
Moon Jun
MJ
Benzel
Edward C
EC
Bingaman
William
W
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001810:Blood Volume; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome