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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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1-year postoperative estimated point defi cit in quality of life estimated by SF-36, 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 patients aged ≥65 years of age, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.
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Figure 0002: 1-year postoperative estimated point defi cit in quality of life estimated by SF-36, 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 patients aged ≥65 years of age, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.

Mentions: 1 year after surgery, the elderly patients generally had more pronounced leg pain, higher consumption of analgesics, shorter walking distance, inferior quality of life (SF-36) (Figure 1), and a higher degree of disability (ODI) than young and middle-aged patients (Tables 2 and 3). The PROM values improved markedly in all patient groups (Figure 1), but in general with less improvement in the elderly patients than in the young and middle-aged patients (Table 4). The exceptions were for the SF-36 subdomains RE (Role emotional), MH (Mental health) and GH (General health), where there were no statistically significant group differences, and for back pain, where elderly patients improved more (Table 4). However, in spite of the improvement both groups still reported impaired clinical status compared to normative age-matched data (Figure 1), with a more pronounced deficit in the elderly (Figure 2). Also, 1 year postoperatively, elderly patients were subjectively less satisfied with the surgical outcome than young and middle-aged patients (p = 0.04) (Table 4).


The outcome of lumbar disc herniation surgery is worse in old adults than in young adults
1-year postoperative estimated point defi cit in quality of life estimated by SF-36, 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 patients aged ≥65 years of age, 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 0002: 1-year postoperative estimated point defi cit in quality of life estimated by SF-36, 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 patients aged ≥65 years of age, and younger refers to the sex-matched comparison group aged 20–64. For Abbreviations, see Table 3.
Mentions: 1 year after surgery, the elderly patients generally had more pronounced leg pain, higher consumption of analgesics, shorter walking distance, inferior quality of life (SF-36) (Figure 1), and a higher degree of disability (ODI) than young and middle-aged patients (Tables 2 and 3). The PROM values improved markedly in all patient groups (Figure 1), but in general with less improvement in the elderly patients than in the young and middle-aged patients (Table 4). The exceptions were for the SF-36 subdomains RE (Role emotional), MH (Mental health) and GH (General health), where there were no statistically significant group differences, and for back pain, where elderly patients improved more (Table 4). However, in spite of the improvement both groups still reported impaired clinical status compared to normative age-matched data (Figure 1), with a more pronounced deficit in the elderly (Figure 2). Also, 1 year postoperatively, elderly patients were subjectively less satisfied with the surgical outcome than young and middle-aged patients (p = 0.04) (Table 4).

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