title: Patient-Rated Outcomes of Lumbar Fusion in Patients With Degenerative Disease of the Lumbar Spine: Does Age Matter?
abstract: METHODS
  Single-center retrospective study of prospectively collected data, nested within the Eurospine Spine Tango data acquisition system.
  
  
  OBJECTIVE
  The aim of this study was to assess the patient-rated outcome and complication rates associated with lumbar fusion procedures in three different age groups.
  
  
  BACKGROUND
  There is a general reluctance to consider spinal fusion procedures in elderly patients due to the increased likelihood of complications.
  
  
  METHODS
  Before and at 3, 12, and 24 months after surgery, patients completed the multidimensional Core Outcome Measures Index. At the 3-, 12-, and 24-month follow-ups, they also rated the Global Treatment Outcome and their satisfaction with care. Patients were divided into three age groups: younger (≥50 years <65 years; n = 317), older (≥65 years <80 years; n = 350), and geriatric (≥80 years; n = 40).
  
  
  RESULTS
  A total of 707 consecutive patients were included. The preoperative comorbidity status differed significantly (P < 0.0001) between the age groups, with the highest scores in the geriatric group. Medical complications during surgery were lower in the younger age group (7%) than in the older (13.4%; P = 0.006) and geriatric groups (17.5%; P = 0.007); surgical complications tended to be higher in the elderly group (younger, 6.3%; older, 6.0%; geriatric, 15.0%; P = 0.09). There were no significant group differences (P > 0.05) for the scores on any of the Core Outcome Measures Index domains, Global Treatment Outcome, or patient-rated satisfaction at either 3-, 12-, and 24-months of follow-up.
  
  
  CONCLUSIONS
  Despite greater comorbidity and complication rates in geriatric patients, the patient-rated outcome was as good in the elderly as it was in younger age groups up to 2 years after surgery. These data indicate that geriatric age needs careful consideration of associated risks but is not per se a contraindication for fusion for lumbar degenerative disease.
  
  
  METHODS
  4.
authors.affiliation: *Spine Center, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland †Department of Research and Development, Schulthess Clinic, Zurich, Switzerland.
authors.forename: Serge
authors.initials: S
authors.lastname: Marbacher
authors.forename: Anne F
authors.initials: AF
authors.lastname: Mannion
authors.forename: Jan-Karl
authors.initials: JK
authors.lastname: Burkhardt
authors.forename: Ralph T
authors.initials: RT
authors.lastname: Schär
authors.forename: François
authors.initials: F
authors.lastname: Porchet
authors.forename: Frank
authors.initials: F
authors.lastname: Kleinstück
authors.forename: Dezsö
authors.initials: D
authors.lastname: Jeszenszky
authors.forename: Tamás F
authors.initials: TF
authors.lastname: Fekete
authors.forename: Daniel
authors.initials: D
authors.lastname: Haschtmann
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000639:trends*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome