Pedicle screw fixation for arthrodesis of the lumbosacral spine in the elderly. An outcome study
| Autor: | Willi Haye, Steven Nagelberg, James C. Thomas, Daniel A. Capen, Russell W. Nelson, Reynold L. Rimoldi, Robert T. Greenfield |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Lumbosacral spine Arthrodesis medicine.medical_treatment Population Bone Screws Postoperative Complications Surveys and Questionnaires medicine Humans Orthopedics and Sports Medicine In patient Pedicle screw fixation education Aged Pain Measurement Aged 80 and over education.field_of_study business.industry Lumbosacral Region Perioperative Middle Aged Surgery Spinal Fusion Treatment Outcome Physical therapy Female Spinal Diseases Neurology (clinical) Fusion rate business Complication Follow-Up Studies |
| Zdroj: | Spine. 23(13) |
| ISSN: | 0362-2436 |
| Popis: | Study Design. An analysis of the outcome and effectiveness of instrumented arthrodesis of the lumbosacral spine in elderly patients conducted using a review of records, assessment of fusion via plain radiographs, and a two-Dart questionnaire. Objective. To ascertain the outcome and efficacy of instrumented arthrodesis of the lumbosacral spine in patients 60 years of age and older. Background Data. From 1987 to 1991, 38 patients of at least 60 years of age underwent instrumented arthrodesis of the lumbosacral spine using the Wiltse or Selby pedicle screw fixation system (Advanced Spine Fixation Systems, inc., irvine, CA). Patients were considered for surgery only after attempts at conservative management, including physical therapy, medication, injection blocks, and home exercises, had proven unsuccessful. Methods. Follow-up examinations were performed 3 months, 6 months, 1 year, and 2 years after surgery. Fusion was assessed using plain radiographs, including fiexion-extension films. Inpatient and outpatient records were reviewed, and a two-part questionnaire was used to establish the effect of surgery on function and lifestyle. Thirty patients responded to the questionnaire. Follow-up observation of the patients ranged from 25 to 56 months. The mean age was 73.8 years (range, 60-90 years). Results. The mean co-morbidity was 1.7. Based on the authors' method of evaluation of fusion, the fusion rate was 92%. Fifty-seven percent of the patients reported excellent or good results, 26% reported fair results, and 17% reported poor results. Functional gains of 50% or more were reported by 71% of the respondents. Female patients had significantiy more complications than male patients, but reported comparable outcomes. Conclusion. Despite the increase in age, co-morbidity, and associated risk of perioperative complications inherent in this population, an outcome comparable with that of younger patients is reported. |
| Databáze: | OpenAIRE |
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