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European Geriatric Medicine

, Volume 10, Issue 1, pp 79–88 | Cite as

Is elective degenerative lumbar spine surgery in older adults safe in a short-stay clinic? Data from an institutional registry

  • Alessandro Siccoli
  • Victor E. StaartjesEmail author
  • Marlies P. de Wispelaere
  • Marc L. Schröder
Research Paper
  • 38 Downloads

Abstract

Purpose

Physicians are increasingly confronted with degenerative spinal pathologies and the possibility of elective surgical treatment in older adults. Little is known on safety and effectiveness of short-stay, elective lumbar spine surgery in this population. We aim to describe patient profiles of older adults undergoing surgery at a specialized short-stay clinic, and describe associated risk profiles and outcomes.

Methods

From a prospective registry, patients older than 65 were compared to younger controls. All patients underwent a strict anesthesiologic screening preoperatively, leading to a carefully selected cohort of relatively robust older adults suited for safe treatment at a short-stay clinic. A range of perioperative data and reoperations were available from all patients, and a subgroup of patients completed outcome assessments for disability, pain, and health-related quality of life (HRQOL).

Results

Of the 3279 included patients, 382 (12%) were older than 65. Older patients presented more often with spinal stenosis, and index levels were placed higher (p < 0.001). While there was no difference in complications, reoperations, and blood loss (p > 0.05), older people had longer surgical times and length of stay, although not by a clinically relevant margin (p < 0.001). Long-term patient-reported outcomes were equal (p > 0.05). However, older adults had worse 6-week outcomes for leg pain, functional disability, and HRQOL (all p < 0.05).

Conclusions

Higher age should not be considered a contraindication for elective lumbar spine surgery at short-stay clinics. If the anesthesiologic risk can be controlled, conservative treatments have failed, and muscle-sparing techniques are applied, favorable outcomes can be achieved with an acceptable risk profile in a safe manner.

Keywords

Short-stay Elective Outpatient Age Geriatric Degenerative 

Notes

Acknowledgements

We cordially thank Femke Beusekamp, BSc, Johan Miedema, MSc, and Nathalie Schouman for their assistance in data collection.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Medical Research Ethics Committees United, Registration Number: W16.065) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

41999_2018_132_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 kb)

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Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryBergman ClinicsAmsterdamThe Netherlands
  2. 2.Faculty of MedicineUniversity of ZurichZurichSwitzerland
  3. 3.Department of Clinical InformaticsBergman ClinicsNaardenThe Netherlands

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