PMID- 35901712 OWN - NLM STAT- MEDLINE DCOM- 20221205 LR - 20240426 IS - 1547-5646 (Electronic) IS - 1547-5654 (Print) IS - 1547-5646 (Linking) VI - 37 IP - 6 DP - 2022 Dec 1 TI - Improvement following minimally invasive lumbar decompression in patients 80 years or older compared with younger age groups. PG - 828-835 LID - 10.3171/2022.5.SPINE22361 [doi] AB - OBJECTIVE: The objective of this study was to assess the outcomes of minimally invasive lumbar decompression in patients >/= 80 years of age and compare them with those of younger age groups. METHODS: This was a retrospective cohort study. Patients who underwent primary unilateral laminotomy for bilateral decompression (ULBD) (any number of levels) and had a minimum of 1 year of follow-up were included and divided into three groups by age: < 60 years, 60-79 years, and >/= 80 years. The outcome measures were 1) patient-reported outcome measures (PROMs) (visual analog scale [VAS] back and leg, Oswestry Disability Index [ODI], 12-Item Short-Form Health Survey [SF-12] Physical Component Summary [PCS] and Mental Component Summary [MCS] scores, and Patient-Reported Outcomes Measurement Information System Physical Function [PROMIS PF]); 2) percentage of patients achieving the minimal clinically important difference (MCID) and the time taken to do so; and 3) complications and reoperations. Two postoperative time points were defined: early (< 6 months) and late (>/= 6 months). RESULTS: A total of 345 patients (< 60 years: n = 94; 60-79 years: n = 208; >/= 80 years: n = 43) were included in this study. The groups had significantly different average BMIs (least in patients aged >/= 80 years), age-adjusted Charlson Comorbidity Indices (greatest in the >/= 80-year age group), and operative times (greatest in 60- to 79-year age group). There was no difference in sex, number of operated levels, and estimated blood loss between groups. Compared with the preoperative values, the < 60-year and 60- to 79-year age groups showed a significant improvement in most PROMs at both the early and late time points. In contrast, the >/= 80-year age group only showed significant improvement in PROMs at the late time point. Although there were significant differences between the groups in the magnitude of improvement (least improvement in >/= 80-year age group) at the early time point in VAS back and leg, ODI, and SF-12 MCS, no significant difference was seen at the late time point except in ODI (least improvement in >/= 80-year group). The overall MCID achievement rate decreased, moving from the < 60-year age group toward the >/= 80-year age group at both the early (64% vs 51% vs 41% ) and late (72% vs 58% vs 52%) time points. The average time needed to achieve the MCID in pain and disability increased, moving from the < 60-year age group toward the >/= 80-year age group (2 vs 3 vs 4 months). There was no significant difference seen between the groups in terms of complications and reoperations except in immediate postoperative complications (5.3% vs 4.8% vs 14%). CONCLUSIONS: Although in this study minimally invasive decompression led to less and slower improvement in patients >/= 80 years of age compared with their younger counterparts, there was significant improvement compared with the preoperative baseline. FAU - Shahi, Pratyush AU - Shahi P AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Song, Junho AU - Song J AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Dalal, Sidhant AU - Dalal S AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Melissaridou, Dimitra AU - Melissaridou D AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Shinn, Daniel J AU - Shinn DJ AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Araghi, Kasra AU - Araghi K AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Mai, Eric AU - Mai E AD - 2Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, New York. FAU - Sheha, Evan AU - Sheha E AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Dowdell, James AU - Dowdell J AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. AD - 2Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, New York. FAU - Iyer, Sravisht AU - Iyer S AD - 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York; and. AD - 2Department of Orthopaedic Surgery, Weill Cornell Medicine, New York, New York. LA - eng GR - UL1 TR002384/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20220701 PL - United States TA - J Neurosurg Spine JT - Journal of neurosurgery. Spine JID - 101223545 SB - IM MH - Humans MH - Middle Aged MH - Aged, 80 and over MH - *Lumbar Vertebrae/surgery MH - Retrospective Studies MH - Treatment Outcome MH - *Decompression, Surgical PMC - PMC11044646 MID - NIHMS1977070 OTO - NOTNLM OT - MCID OT - elderly OT - lumbar decompression OT - minimally invasive OT - octogenarian OT - outcomes EDAT- 2022/07/29 06:00 MHDA- 2022/12/06 06:00 PMCR- 2024/04/25 CRDT- 2022/07/28 18:24 PHST- 2022/04/01 00:00 [received] PHST- 2022/05/16 00:00 [accepted] PHST- 2022/07/29 06:00 [pubmed] PHST- 2022/12/06 06:00 [medline] PHST- 2022/07/28 18:24 [entrez] PHST- 2024/04/25 00:00 [pmc-release] AID - 10.3171/2022.5.SPINE22361 [doi] PST - epublish SO - J Neurosurg Spine. 2022 Jul 1;37(6):828-835. doi: 10.3171/2022.5.SPINE22361. Print 2022 Dec 1.