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The outcome of lumbar disc herniation surgery is worse in old adults than in young adults

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ABSTRACT

Background and purpose: The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients.

Patients and methods: With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000–2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20–64).

Results: Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant).

Interpretation: Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery.

No MeSH data available.


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Quality of life estimated by SF-36, pre- and postoperatively, in elderly and younger patients operated for LDH compared to a published age-matched reference data population* (Sullivan et al. 1994). Elderly is defi ned as those aged ≥65 years, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.
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Figure 0001: Quality of life estimated by SF-36, pre- and postoperatively, in elderly and younger patients operated for LDH compared to a published age-matched reference data population* (Sullivan et al. 1994). Elderly is defi ned as those aged ≥65 years, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.

Mentions: 53% of the elderly patients were males, with a mean age of 71 (SD 5.3) years, and the 47% who were women had a mean age of 72 (SD 5.5) years. 55% of the the young and middle-aged patients were males, with a mean age of 43 (SD 10.3) years, and the 45% who were women had a mean age of 43 (SD 10.2) years. Further background data are presented in Tables 2 and 3. In addition to discectomy, 19% of the elderly cohort and 12% of the younger cohort also had decompressive surgery. Elderly patients had more pronounced back and leg pain, shorter walking distance, inferior quality of life (SF-36) (Figure 1), and a higher degree of disability (ODI) (Tables 2 and 3) than young and middle-aged patients, and—in all age groups—with severe impairment in all PROMs compared to normative age-matched data (Fairbank et al. 1980, Sullivan et al. 1994, Fairbank and Pynsent 2000) (Tables 2 and 3, and Figure 1).


The outcome of lumbar disc herniation surgery is worse in old adults than in young adults
Quality of life estimated by SF-36, pre- and postoperatively, in elderly and younger patients operated for LDH compared to a published age-matched reference data population* (Sullivan et al. 1994). Elderly is defi ned as those aged ≥65 years, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016912&req=5

Figure 0001: Quality of life estimated by SF-36, pre- and postoperatively, in elderly and younger patients operated for LDH compared to a published age-matched reference data population* (Sullivan et al. 1994). Elderly is defi ned as those aged ≥65 years, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.
Mentions: 53% of the elderly patients were males, with a mean age of 71 (SD 5.3) years, and the 47% who were women had a mean age of 72 (SD 5.5) years. 55% of the the young and middle-aged patients were males, with a mean age of 43 (SD 10.3) years, and the 45% who were women had a mean age of 43 (SD 10.2) years. Further background data are presented in Tables 2 and 3. In addition to discectomy, 19% of the elderly cohort and 12% of the younger cohort also had decompressive surgery. Elderly patients had more pronounced back and leg pain, shorter walking distance, inferior quality of life (SF-36) (Figure 1), and a higher degree of disability (ODI) (Tables 2 and 3) than young and middle-aged patients, and—in all age groups—with severe impairment in all PROMs compared to normative age-matched data (Fairbank et al. 1980, Sullivan et al. 1994, Fairbank and Pynsent 2000) (Tables 2 and 3, and Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients.

Patients and methods: With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000–2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20–64).

Results: Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant).

Interpretation: Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery.

No MeSH data available.


Related in: MedlinePlus