TITLE

Outcome of Lumbar Arthrodesis in Patients Sixty-five Years of Age or Older

AUTHOR(S)
Glassman, Steven D.; Carreon, Leah; Dimar, John R.
PUB. DATE
March 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2010 Supplement 1, Vol. 92-A, p77
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BACKGROUND: The value of lumbar spine arthrodesis in older patients is not well documented. As most of the literature regarding lumbar arthrodesis in older patients has focused on the prevalence of complications, the purpose of this study was to determine the clinical outcomes for older compared with younger patients undergoing lumbar arthrodesis. METHODS: We studied 224 patients who underwent a single-level posterolateral lumbar arthrodesis with an iliac crest bone graft. Outcome measures included the Oswestry Disability Index, the Medical Outcomes Study Short Form-36 and numeric rating scales for back and leg pain, as well as a radiographic assessment of fusion. Outcome measures were evaluated on the basis of the mean change and the percentage of patients reaching a minimum clinically important difference threshold. For comparison, the patients were divided into two groups: 174 patients who were younger than sixty-five years and fifty patients who were sixty-five years of age or older. RESULTS: Substantial improvements from baseline were noted in all of the clinical and health-related quality-of-life measures at the six-month, one-year, and two-year intervals. The mean improvements in the Oswestry Disability Index score at two years postoperatively were 28.5 points for the older patients and 24.5 points for the younger patients. For Short Form-36 physical component summary scores, the mean improvement from baseline was 14.2 points for the older group and 11.7 points for the younger group at two years. The older patients also demonstrated a similar or greater improvement in the numeric rating scale back and leg pain scores at all time intervals, with a significant difference in leg pain scores at two years postoperatively (10.4 points for the older patients and 6.4 points for the younger patients; p = 0.002). Perioperative complications, although an obvious concern, did not appear to adversely affect clinical and health-related quality-of-life outcomes at two years postoperatively. CONCLUSIONS: This study demonstrates a substantial benefit for patients sixty-five years of age or older with degenerative disc disease who are treated with a single-level lumbar decompression and instrumented arthrodesis, and we conclude that lumbar arthrodesis is a viable and reasonable treatment option for appropriately selected patients sixty-five years of age or older. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
48654211

 

Related Articles

  • Jumbo cups for revision of acetabular defects after total hip arthroplasty: a retrospective review of a case series. Wedemeyer, Christian; Neuerburg, Carl; Heep, Hansjoerg; Von Knoch, Fabian; Von Knoch, Marius; Löer, Franz; Saxler, Guido // Archives of Orthopaedic & Trauma Surgery;Jun2008, Vol. 128 Issue 6, p545 

    The treatment of acetabular bone defects presents a great challenge in revision total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiological outcome of revision THA using jumbo cups for acetabular reconstruction after applying the bone-grafting technique....

  • Outcomes and Second-Look Arthroscopic Evaluation After Double-Bundle Anterior Cruciate Ligament Reconstruction with Use of a Single Tibial Tunnel. Jin Hwan Ahn; Sang-Hee Choi; Joon Ho Wang; Jae Chul Yoo; Hyun Seok Yim; Moon Jong Chang // Journal of Bone & Joint Surgery, American Volume;10/19/2011, Vol. 93-A Issue 20, p1865 

    Background: The correlation between graft appearance and clinical outcome after double-bundle anterior cruciate ligament (ACL) reconstruction is a major concern. In this study, the graft appearance was assessed with use of secondlook arthroscopy and was correlated with the clinical outcome....

  • Lumbar Total Disc Replacement. Tropiano, Patrick; Huang, Russel C.; Girardi, Federico P.; Cammisa Jr., Frank P.; Marnay, Thierry // Journal of Bone & Joint Surgery, American Volume;Mar2006 Supplement 1, Vol. 88-A, p50 

    BACKGROUND: Symptomatic lumbar degenerative disc disease is a challenging entity to treat. The results of arthrodesis may be compromised in the short term by pseudarthrosis and in the long term by pain at the iliac-crest donor site and by junctional degeneration. Total disc replacement has the...

  • Computer-Assisted Surgery for Subtalar Arthrodesis. Easley, Mark; Chuckpaiwong, Bavornrit; Cooperman, Nathan; Schuh, Reinhard; Ogut, Tahir; Le, Ian L. D.; Reach, John // Journal of Bone & Joint Surgery, American Volume;Aug2008, Vol. 90-A Issue 8, p1628 

    Background: Despite considerable recent interest in computer navigation for orthopaedic surgery, few investigations of computer-assisted surgery for foot and ankle operations have been reported. The purpose of the present study was to compare subtalar arthrodesis with and without computer...

  • Outcome of Lumbar Arthrodesis in Patients Sixty-five Years of Age or Older. Glassman, Steven D.; Polly, David W.; Bono, Christopher M.; Burkus, Kenneth; Dimar, John R. // Journal of Bone & Joint Surgery, American Volume;Apr2009, Vol. 91-A Issue 4, p783 

    Background: The value of lumbar spine arthrodesis in older patients is not well documented. As most of the literature regarding lumbar arthrodesis in older patients has focused on the prevalence of complications, the purpose of this study was to determine the clinical outcomes for older compared...

  • Conversion of Painful Ankle Arthrodesis to Total Ankle Arthroplasty. Hintermann, Beat; Barg, Alexej; Knupp, Markus; Valderrabano, Victor // Journal of Bone & Joint Surgery, American Volume;Apr2009, Vol. 91-A Issue 4, p850 

    Background: Pain following an ankle arthrodesis continues to be a challenging clinical problem. Recent reports on semiconstrained two-component ankle implants have demonstrated the feasibility of reversing a problematic ankle fusion and converting it to a total ankle arthroplasty. However, the...

  • Patient-based outcomes for the operative treatment of degenerative lumbar spinal stenosis. Fokter, Samo K.; Yerby, Scott A. // European Spine Journal;Nov2006, Vol. 15 Issue 11, p1661 

    Study design: A retrospective surgical case series was conducted using a condition-specific, patient-based outcomes assessment. Objective: The goal of this study was to describe the outcome predictors of decompressive surgery for degenerative lumbar spinal stenosis (DLSS). Summary of background...

  • Outcomes of an Anatomic Posterolateral Knee Reconstruction. Apsingi, Sunil; Eachampati, K. K.; LaPrade, Robert F.; Johansen, Steinar; Engebretsen, Lars // Journal of Bone & Joint Surgery, American Volume;2/16/2011, Vol. 93-A Issue 4, pe12-1 

    The article presents a letter to the editor in response to the report "Outcomes of an Anatomic Posterolateral Knee Reconstruction," by Robert F. LaPrade and team from volume 92, 2010, as well as a reply by the authors.

  • Uninstrumented In Situ Fusion for High-Grade Childhood and Adolescent Isthmic Spondylolisthesis: Long-Term Outcome. Lamberg, Tommi; Remes, Ville; Helenius, Ilkka; Schlenzka, Dietrich; Seitsalo, Seppo; Poussa, Mikko // Journal of Bone & Joint Surgery, American Volume;Mar2007, Vol. 89-A Issue 3, p512 

    Background: Intermediate-term radiographic studies have shown that anterior and circumferential techniques result in high fusion rates in patients with high-grade spondylolisthesis, whereas posterolateral fusion is less successful. We are not aware of any long-term comparative studies in which...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics