The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis.

Autor:	Mekhail NA; Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA., Costandi SJ; Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA., Armanyous S; Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA., Vallejo R; Millennium Pain Center, Bloomington, IL, USA., Poree LR; Pain Management Center, UCSF Health, San Francisco, CA, USA., Brown LL; TruWell Health, St. Petersburg, FL, USA., Golovac S; Florida Pain Institute, Merritt Island, FL, USA., Deer TR; Center for Pain Relief, Charleston, WV, USA.
Jazyk:	angličtina
Zdroj:	Medical devices (Auckland, N.Z.) [Med Devices (Auckl)] 2020 Jun 04; Vol. 13, pp. 151-161. Date of Electronic Publication: 2020 Jun 04 (Print Publication: 2020).
DOI:	10.2147/MDER.S251556
Abstrakt:	Background and Purpose: Minimally invasive lumbar decompression ( mild ® ) is an effective long-term therapy for patients with symptomatic lumbar spinal stenosis (LSS) resulting primarily from hypertrophic ligamentum flavum (HLF). Most subjects in clinical studies of the mild procedure have been older adults (age≥65). While the incidence of LSS increases with age, a substantial number of adults (age<65) also suffer from neurogenic claudication secondary to HLF. In this report, outcomes of mild were compared between adults and older adults. Patients and Methods: All prospective studies of the mild procedure with a 1-year follow-up completed since the beginning of 2012 that allowed the inclusion of adult patients of all ages were reviewed. Outcomes of visual analog scale (VAS), Oswestry Disability Index (ODI), Pain Disability Index (PDI), Roland Morris Low Back Pain and Disability Questionnaire (RMQ), standing time and walking distance were compared for adults and older adults. Results: Four studies met the inclusion criteria, resulting in an analysis of 49 adults and 160 older adults. Patients in both age groups experienced significant mean improvements in all but one outcome measure at 6- and 12-month follow-up. Differences between the two age groups in all scores at 6 and 12 months were not statistically significant. Conclusion: Analysis of the four studies indicated that symptom improvements for adults and older adults were significant from baseline, and no statistically significant difference was observed between the two age groups. These results illustrate that mild can be an effective treatment for LSS due primarily to HLF, regardless of the adult patient age. Competing Interests: Dr Nagy A Mekhail reports personal fees from Abbott, Boston Scientific, Sollis Therapeutics, Relievant Medsystems, Saluda Medical, Nevro, Vertos Medical, and Nuvectra, grants from Mallinckrodt, Mesoblast, Halyard, Neuros Medical, outside the submitted work. Dr Timothy R Deer reports grants, personal fees from and is a consultant and research investigator including stock option for Vertos Medical and Vertiflex, during the conduct of the study. He also reports personal fees from Abbott, Flowonix, Axonics, SpineThera, Saluda Medical, Mainstay Medical, Nalu, Cornerloc, Ethos, SPR Therapeutics, Stimgenics, SI Bone, Nevro, Medtronic as consultant, advisory board member, and/or research investigator, outside the submitted work. In addition, Dr Timothy R Deer has a patent pending with Abbott. The authors report no other conflicts of interest in this work. (© 2020 Mekhail et al.)
Databáze:	MEDLINE
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