Minimally invasive transforaminal lumbar fusion yields promising outcomes in older adults
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SAN DIEGO — Older adults who undergo minimally invasive transforaminal lumbar interbody fusion have comparable pain, disability and quality of life outcomes with younger adults, according to a presenter.
“Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) may be beneficial in elderly patients in whom the decreased surgical morbidity and faster recovery may have more profound implications,” Graham S. Goh, MD, a research fellow at Rothman Orthopaedic Institute, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “However, elderly patients are often reluctant to undergo a spinal surgery based on the assumption that they may have a poorer recovery.”
Goh and colleagues retrospectively reviewed data for 120 patients who underwent a primary single-level MIS TLIF for degenerative spondylolisthesis. Researchers analyzed one cohort, which consisted of 30 patients with a mean age of 73.5 years, and a control cohort, which consisted of 90 patients with a mean age of 58.3 years. Outcome measures included the Oswestry disability index (ODI), SF-36 physical and mental component scores (SF-36 PCS and SF-36 MCS), VAS pain scores, patient satisfaction and revisions. According to the abstract, these outcomes were analyzed at 6 months, 2 years and 5 years.
Goh and colleagues found older adult patients had a longer length of stay and more readmissions; however, there were no differences between the cohorts in operative time, transfusions, complications or discharge disposition, Goh noted. Older adult patients also had no revisions compared with three revisions (3.3%) in the control cohort. Additionally, no differences were found in ODI, VAS back pain, SF-36 PCS or SF-36 MCS at 5-year follow-up between the cohorts.
These results were sustained at 5 years and did not show any deterioration, Goh added.
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Goh GS, et al. Paper 475. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Aug. 31 - Sept. 3, 2021; San Diego.
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