PMID- 33999871
OWN - NLM
STAT- MEDLINE
DCOM- 20210824
LR  - 20230714
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 29
IP  - 17
DP  - 2021 Sep 1
TI  - Impact of Advanced Age on Postoperative Outcomes Following Transforaminal Lumbar 
      Interbody Fusion.
PG  - e869-e879
LID - 10.5435/JAAOS-D-20-01382 [doi]
AB  - INTRODUCTION: Age 65 years or older is considered a risk factor for worse 
      outcomes after transforaminal lumbar interbody fusion (TLIF). However, few 
      studies have differentiated this cohort from younger patients. This study 
      compares postoperative outcomes among patients 65 years or older of age with a 
      younger cohort after minimally invasive (MIS) TLIF. METHODS: A database was 
      reviewed for adults undergoing primary, elective, single-level MIS TLIF 
      procedures for degenerative pathology from 2008 to 2019. Outcomes included visual 
      analogue scale (VAS) for back and leg, Oswestry Disability Index (ODI), Short 
      Form 12-Item physical component score (SF-12 PCS), and Patient-Reported Outcome 
      Measurement Information System physical function. Outcomes were collected 
      preoperatively and at 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. 
      Patients were categorized as >/=75 years, 65 to 74 years, or <65 years of age. 
      Propensity score matching was performed, and outcome improvement and minimum 
      clinically important difference (MCID) achievement were evaluated by group. MCID 
      achievement was calculated using previously established values. RESULTS: Our 
      cohort included 51 patients aged younger than 65 years, 47 patients aged 65 to 74 
      years, and 16 patients aged 75 years or older. No significant perioperative 
      differences or complications existed between groups. The 65- to 74-year group 
      improved in VAS back, leg, and ODI from 6 weeks to 1 year (all P < 0.001) and 
      SF-12 PCS at 12 weeks to 1 year (all P < 0.005). VAS back, ODI, and SF-12 PCS 
      differed between groups preoperatively (P < 0.050), and VAS back and ODI varied 
      at 6 weeks (P < 0.01). VAS leg differed between groups at 12 weeks and SF-12 PCS 
      at 1 year (both P < 0.050). MCID achievement was similar between groups except 
      for VAS leg at 6 weeks (P = 0.038) and 12 weeks (P = 0.023). CONCLUSION: Patients 
      65 years or older of age markedly improved from baseline, similarly to younger 
      patients. Postoperative outcome scores and MCID achievement demonstrated 
      differences between groups at intermittent timepoints. With appropriate selection 
      criteria, patient age may not act as a notable risk factor for successful MIS 
      TLIF procedures.
CI  - Copyright (c) 2021 by the American Academy of Orthopaedic Surgeons.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - From the Department of Orthopaedic Surgery, Rush University Medical Center, 
      Chicago, IL.
FAU - Cha, Elliot D K
AU  - Cha EDK
AUID- ORCID: 0000-0001-8118-008
FAU - Lynch, Conor P
AU  - Lynch CP
AUID- ORCID: 0000-0002-9554-2878
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
FAU - Jadczak, Caroline N
AU  - Jadczak CN
FAU - Singh, Kern
AU  - Singh K
AUID- ORCID: 0000-0002-6118-7273
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Acad Orthop Surg
JT  - The Journal of the American Academy of Orthopaedic Surgeons
JID - 9417468
SB  - IM
MH  - Adult
MH  - Aged
MH  - Humans
MH  - *Lumbar Vertebrae/surgery
MH  - Lumbosacral Region
MH  - Minimally Invasive Surgical Procedures
MH  - Patient Reported Outcome Measures
MH  - *Spinal Fusion/adverse effects
MH  - Treatment Outcome
EDAT- 2021/05/18 06:00
MHDA- 2021/08/25 06:00
CRDT- 2021/05/17 17:26
PHST- 2020/12/16 00:00 [received]
PHST- 2021/04/04 00:00 [accepted]
PHST- 2021/05/18 06:00 [pubmed]
PHST- 2021/08/25 06:00 [medline]
PHST- 2021/05/17 17:26 [entrez]
AID - 00124635-202109010-00009 [pii]
AID - 10.5435/JAAOS-D-20-01382 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2021 Sep 1;29(17):e869-e879. doi: 
      10.5435/JAAOS-D-20-01382.