Outcomes and Complications With Age in Spondylolisthesis: An Evaluation of the Elderly From the Quality Outcomes Database.

dc.contributor.author

Karsy, Michael

dc.contributor.author

Chan, Andrew K

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Mummaneni, Praveen V

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Virk, Michael S

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Bydon, Mohamad

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Glassman, Steven D

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Foley, Kevin T

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Potts, Eric A

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Shaffrey, Christopher I

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Shaffrey, Mark E

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Coric, Domagoj

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Asher, Anthony L

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Knightly, John J

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Park, Paul

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Fu, Kai-Ming

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Slotkin, Jonathan R

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Haid, Regis W

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Wang, Michael

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Bisson, Erica F

dc.date.accessioned

2023-06-19T20:03:50Z

dc.date.available

2023-06-19T20:03:50Z

dc.date.issued

2020-07

dc.date.updated

2023-06-19T20:03:50Z

dc.description.abstract

Study design

Prospective database analysis.

Objective

To assess the effect of age on patient-reported outcomes (PROs) and complication rates after surgical treatment for spondylolisthesis SUMMARY OF BACKGROUND DATA.: Degenerative lumbar spondylolisthesis affects 3% to 20% of the population and up to 30% of the elderly. There is not yet consensus on whether age is a contraindication for surgical treatment of elderly patients.

Methods

The Quality Outcomes Database lumbar registry was used to evaluate patients from 12 US academic and private centers who underwent surgical treatment for grade 1 lumbar spondylolisthesis between July 2014 and June 2016.

Results

A total of 608 patients who fit the inclusion criteria were categorized by age into the following groups: less than 60 (n = 239), 60 to 70 (n = 209), 71 to 80 (n = 128), and more than 80 (n = 32) years. Older patients showed lower mean body mass index (P < 0.001) and higher rates of diabetes (P = 0.007), coronary artery disease (P = 0.0001), and osteoporosis (P = 0.005). A lower likelihood for home disposition was seen with higher age (89.1% in <60-year-old vs. 75% in >80-year-old patients; P = 0.002). There were no baseline differences in PROs (Oswestry Disability Index, EuroQol health survey [EQ-5D], Numeric Rating Scale for leg pain and back pain) among age categories. A significant improvement for all PROs was seen regardless of age (P < 0.05), and most patients met minimal clinically important differences (MCIDs) for improvement in postoperative PROs. No differences in hospital readmissions or reoperations were seen among age groups (P < 0.05). Multivariate analysis demonstrated that, after controlling other variables, a higher age did not decrease the odds of achieving MCID at 12 months for the PROs.

Conclusion

Our results indicate that well-selected elderly patients undergoing surgical treatment of grade 1 spondylolisthesis can achieve meaningful outcomes. This modern, multicenter US study reflects the current use and limitations of spondylolisthesis treatment in the elderly, which may be informative to patients and providers.

Level of evidence

4.
dc.identifier

00007632-202007150-00017

dc.identifier.issn

0362-2436

dc.identifier.issn

1528-1159

dc.identifier.uri

https://hdl.handle.net/10161/28141

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Spine

dc.relation.isversionof

10.1097/brs.0000000000003441

dc.subject

Lumbar Vertebrae

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Humans

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Spondylolisthesis

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Diabetes Mellitus

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Postoperative Complications

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Treatment Outcome

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Aged

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Aged, 80 and over

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Middle Aged

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Coronary Artery Disease

dc.title

Outcomes and Complications With Age in Spondylolisthesis: An Evaluation of the Elderly From the Quality Outcomes Database.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1000

pubs.end-page

1008

pubs.issue

14

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

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Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

45

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