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



Prospective data from the Norwegian Registry for Spine Surgery.



Multicenter observational study.



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)).



Laminectomy or microdecompression.



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.



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).



Individuals aged 80 and older experience improvement in self-reported outcomes similar to those of younger individuals after decompressive surgery for LSS.
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. charalampis.giannadakis@ntnu.no.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. charalampis.giannadakis@ntnu.no.
Charalampis
C
Giannadakis
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|National Competence Center for Ultrasound and Image Guided Therapy, St. Olavs University Hospital, Trondheim, Norway.
Ole
O
Solheim
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Asgeir S
AS
Jakola
Department of Anesthesia, St. Olavs University Hospital, Trondheim, Norway.|Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Trond
T
Nordseth
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway.
Agnete M
AM
Gulati
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Ulf S
US
Nerland
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway.|Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway, Tromsø, Norway.
Øystein P
ØP
Nygaard
Norwegian National Registry for Spine Surgery, University Hospital of Northern Norway, Tromsø, Norway.|Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway.
Tore K
TK
Solberg
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|National Advisory Unit on Spinal Surgery Center for Spinal Disorders, St. Olavs University Hospital, Trondheim, Norway.|Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway.
Sasha
S
Gulati
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D004185:Disability Evaluation; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000473:pathology; D009664:Norway / Q000453:epidemiology; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D013130:Spinal Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome
neurosurgical procedures; quality of life; self-reported outcomes; spinal stenosis; spondylosis