Strömqvist Fredrik, Strömqvist Björn, Jönsson Bo, Karlsson Magnus K
a Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics , Lund University, Skane University Hospital , Malmö , Sweden .
Acta Orthop. 2016 Oct;87(5):516-21. doi: 10.1080/17453674.2016.1205173. Epub 2016 Jul 8.
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.
背景与目的——腰椎间盘突出症（LDH）手术治疗的结果在中年患者中已得到充分评估，但在老年患者中的评估较少。患者与方法——采用经过验证的患者报告结局测量指标（PROMs），并利用瑞典脊柱外科国家注册中心（SweSpine），我们分析了2000年至2012年期间LDH患者的术前临床状况以及LDH手术的术后1年结局。我们纳入了1250例老年患者（≥65岁）和12840例中青年患者（20 - 64岁）。结果——总体而言，老年患者因LDH手术就诊时的PROM评分比中青年患者差，手术改善程度较小，经历更多并发症，术后1年的PROM评分较低，且对结局的满意度较低（所有差异均具有统计学意义）。解读——老年患者LDH手术后的结局似乎比中青年患者差，他们因临床状况较差而接受手术，且术后改善较少。
