PMID- 21217437
OWN - NLM
STAT- MEDLINE
DCOM- 20110916
LR  - 20151119
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 36
IP  - 13
DP  - 2011 Jun
TI  - Health-related quality of life after posterolateral lumbar arthrodesis in 
      patients seventy-five years of age and older.
PG  - 1065-8
LID - 10.1097/BRS.0b013e3181e8afa0 [doi]
AB  - STUDY DESIGN: Retrospective cohort analysis of prospectively collected data. 
      OBJECTIVE: The purpose of this study is to report health-related quality of life 
      (HRQOL) outcomes in patients 75 years of age and older who underwent one- to 
      two-level instrumented posterolateral lumbar arthrodesis. SUMMARY OF BACKGROUND 
      DATA: HRQOL measures are increasingly used to measure clinical success after 
      spinal surgery. There is limited data available to guide the clinician caring for 
      the growing geriatric population with degenerative lumbar spine conditions. 
      METHODS: From a database of prospectively collected HRQOL measures in patients 
      undergoing instrumented lumbar arthrodesis, we identified 35 patients 75 years of 
      age and older who underwent one- or two-level instrumented posterolateral lumbar 
      arthrodesis who had complete preoperative and 2-year postoperative data. HRQOL 
      measures included the Oswestry Disability Index (ODI), Short Form-36 Physical 
      Component Score (PCS) and Mental Component Score (MCS), and back and leg pain 
      numerical rating scales. Paired sample t tests were used to compare preoperative 
      and 2-year postoperative scores. The percentage of patients reaching previously 
      established thresholds for Minimum Clinically Important Difference (MCID) and 
      Substantial Clinical Benefit (SCB) were calculated. RESULTS: There were 11 men 
      and 24 women with a mean age of 78.3 years (range 75-85). Diagnoses included 
      stenosis (20), spondylolisthesis (12), instability (1), disc pathology (1), and 
      scoliosis (1). Twelve patients (34%) had complications, 8 (23%) major and 4 (11%) 
      minor. There was a statistically significant improvement in all of the HRQOL 
      measures from preoperative to 2-years postoperative. Sixty percent (21 of 35) of 
      the patients reached the MCID threshold for ODI, PCS, and leg pain, whereas 83% 
      (29 of 35) reached the MCID for back pain. More than half of the patients reached 
      the SCB threshold for leg pain (19 of 35, 54%), back pain (21 of 35, 60%), ODI 
      (19 of 35, 54%), and PCS (21 of 35, 60%). CONCLUSIONS: Properly selected patients 
      75 years of age and older can achieve substantial clinical improvements, based on 
      patient reported HRQOL measures, 2 years after one- and two-level instrumented 
      posterolateral lumbar arthrodesis.
FAU - Crawford, Charles H 3rd
AU  - Crawford CH 3rd
AD  - Department of Orthopaedic Surgery, University of Louisville School of Medicine, 
      KY, USA.
FAU - Smail, Jennifer
AU  - Smail J
FAU - Carreon, Leah Y
AU  - Carreon LY
FAU - Glassman, Steven D
AU  - Glassman SD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthrodesis/*adverse effects/instrumentation/psychology
MH  - Disability Evaluation
MH  - Female
MH  - Health Services Research
MH  - *Health Services for the Aged
MH  - Humans
MH  - Kentucky
MH  - Lumbar Vertebrae/physiopathology/*surgery
MH  - Male
MH  - Pain Measurement
MH  - Pain, Postoperative/etiology/psychology
MH  - Patient Selection
MH  - Postoperative Complications/diagnosis/*etiology/psychology
MH  - *Quality of Life
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Spinal Diseases/diagnosis/physiopathology/psychology/*surgery
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2011/01/11 06:00
MHDA- 2011/09/17 06:00
CRDT- 2011/01/11 06:00
PHST- 2011/01/11 06:00 [entrez]
PHST- 2011/01/11 06:00 [pubmed]
PHST- 2011/09/17 06:00 [medline]
AID - 10.1097/BRS.0b013e3181e8afa0 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2011 Jun;36(13):1065-8. doi: 10.1097/BRS.0b013e3181e8afa0.