PMID- 31407560
OWN - NLM
STAT- MEDLINE
DCOM- 20191015
LR  - 20220410
IS  - 1002-1892 (Print)
IS  - 1002-1892 (Linking)
VI  - 33
IP  - 8
DP  - 2019 Aug 15
TI  - [An age-stratified follow-up of complications and clinical benefit of posterior 
      lumbar intervertebral fusion procedure in middle-aged and older patients].
PG  - 996-1005
LID - 10.7507/1002-1892.201902003 [doi]
AB  - OBJECTIVE: To compare the complications and clinical scores of posterior lumbar 
      intervertebral fusion (PLIF) in middle-aged and older patients of different ages, 
      and to assess the risk of complications of PLIF in different ages, providing a 
      reference for clinical treatment. METHODS: The clinical data of 1 136 patients, 
      who were more than 55 years old and underwent PLIF between June 2013 and June 
      2016, were retrospectively analyzed. According to the age of patients undergoing 
      surgery, they were divided into 3 groups as 55-64 years old, 65-74 years old, and 
      >/=75 years old. The general characteristics, comorbidities, and surgical data of 
      the three groups were compared, with comparison the morbidity of complications. 
      According to the minimal clinical important difference (MCID), the improvement of 
      patient's pain visual analogue scale (VAS) score and the Oswestry disability 
      index (ODI) score were compared. Univariate logistic regression analysis was used 
      to analyze the difference of complications and the improvement of VAS and ODI 
      scores. Multivariate logistic regression analysis was performed for the risk 
      factors of complications. RESULTS: There were significant differences in the 
      number of surgical fusion segments and osteoporosis between groups ( P<0.05); 
      there was no significant difference in gender, body mass index, operation time, 
      preoperative American Society of Anesthesiologists (ASA) classification, and 
      comorbidities between groups ( P>0.05). All patients were followed up 6-62 months 
      with an average of 27.4 months. Among the results of postoperative complications, 
      there were significant differences in the total incidence of intraoperative 
      complications, systemic complications, minor complications, and the percentage of 
      improvement of ODI score to MCID between groups ( P<0.05); but there was no 
      significant difference in the total incidence of complications at the end of 
      long-term follow-up and the percentage of improvement of VAS score to MCID 
      between groups ( P>0.05). Univariate logistic regression analysis showed that 
      after adjusting the confounding factors, there were significant differences in 
      intraoperative complications and the percentage of improvement of ODI score to 
      MCID between 55-64 and 65-74 years old groups ( P<0.05); systemic complications, 
      minor complications, complications at the end of long-term follow-up, and the 
      percentage of improvement of ODI score to MCID in >/=75 years old group were 
      significantly different from those in the other two groups ( P<0.05). 
      Multivariate logistic regression analysis showed that age was a risk factor for 
      systemic complications, minor complications, and complications at the end of 
      long-term follow-up. Except for age, long operation time was a risk factor for 
      intraoperative complications, increased number of fusion segments was a risk 
      factor for systemic complications, the number of comorbidities was a risk factor 
      for minor complications, and osteoporosis was a risk factor for complications at 
      the end of long-term follow-up. CONCLUSION: The risk of surgical complications is 
      higher in the elderly patients (>/=75 years) with lumbar degenerative diseases than 
      in the middle-aged and older patients (<75 years), while the improvements of 
      postoperative VAS and ODI scores were similar. Under the premise of fully 
      assessing surgical indications, PLIF has a positive effect on improving the 
      elderly patients' quality of life.
FAU - Zhou, Bolin
AU  - Zhou B
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.
FAU - Li, Weishi
AU  - Li W
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.wslee72@163.com.
FAU - Chen, Zhongqiang
AU  - Chen Z
AD  - Department of Orthopedics, Peking University International Hospital, Beijing, 
      102206, P.R.China.
FAU - Qi, Qiang
AU  - Qi Q
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.
FAU - Guo, Zhaoqing
AU  - Guo Z
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.
FAU - Zeng, Yan
AU  - Zeng Y
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.
FAU - Sun, Chuiguo
AU  - Sun C
AD  - Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, 
      P.R.China.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
JT  - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = 
      Chinese journal of reparative and reconstructive surgery
JID - 9425194
SB  - IM
MH  - Aged
MH  - Follow-Up Studies
MH  - Humans
MH  - Lumbar Vertebrae
MH  - Middle Aged
MH  - Quality of Life
MH  - Retrospective Studies
MH  - *Spinal Fusion
PMC - PMC8337904
OTO - NOTNLM
OT  - Posterior lumbar intervertebral fusion
OT  - complication
OT  - influencing factor
OT  - middle-aged and older patient
COIS- 利益冲突：所有作者声明，在课题研究和文章撰写过程中不存在利益冲突。
EDAT- 2019/08/14 06:00
MHDA- 2019/10/16 06:00
PMCR- 2019/08/01
CRDT- 2019/08/14 06:00
PHST- 2019/08/14 06:00 [entrez]
PHST- 2019/08/14 06:00 [pubmed]
PHST- 2019/10/16 06:00 [medline]
PHST- 2019/08/01 00:00 [pmc-release]
AID - zgxfcjwkzz-33-8-996 [pii]
AID - 10.7507/1002-1892.201902003 [doi]
PST - ppublish
SO  - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug 15;33(8):996-1005. doi: 
      10.7507/1002-1892.201902003.