Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital.
Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital.
Clin Spine Surg. 2021 May 1;34(4):E223-E228. doi: 10.1097/BSD.0000000000001101.
Retrospective cohort study.
To clarify the poor patient satisfaction after lumbar spinal surgery in elderly patients.
As the global population continues to age, it is important to consider the surgical outcome and patient satisfaction in the elderly. No studies have assessed patient satisfaction in elderly patients undergoing surgical treatment and risk factors for poor satisfaction in elderly patients after lumbar spinal surgery.
A retrospective multicenter survey was performed in 169 patients aged above 80 years who underwent lumbar spinal surgery. Patients were followed up for at least 1 year after surgery. We assessed patient satisfaction from the results of surgery by using a newly developed patient questionnaire. Patients were assessed by demographic data, surgical procedures, complications, reoperation rate, pain improvement, and risk factors for poor patient satisfaction with surgery for lumbar spinal disease.
In total, 131 patients (77.5%, G-group) were satisfied and 38 patients (22.5%, P-group) were dissatisfied with surgery. The 2 groups did not differ significantly in baseline characteristics and surgical data. Postoperative visual analog scale score for low back pain and leg pain were significantly higher in the P-group than in the G-group (low back pain: G-group, 1.7±1.9 vs. P-group, 5.2±2.5, P<0.001; leg pain: G-group, 1.4±2.0 vs. P-group, 5.5±2.6, P<0.001). Multivariate regression analysis revealed that postoperative vertebral fracture (P=0.049; odds ratio, 3.096; 95% confidence interval, 1.004-9.547) and reoperation (P=0.025; odds ratio, 5.692; 95% confidence interval, 1.250-25.913) were significantly associated with the patient satisfaction after lumbar spinal surgery.
Postoperative vertebral fracture and reoperation were found to be risk factors for poor patient satisfaction after lumbar spinal surgery in elderly patients, which suggests a need for careful treatment of osteoporosis in addition to careful determination of surgical indication and procedure in elderly patients.
Level III.
回顾性队列研究。
阐明老年人腰椎手术后较差的患者满意度。
随着全球人口老龄化，考虑老年人的手术结果和患者满意度非常重要。目前尚无研究评估接受手术治疗的老年患者的患者满意度以及腰椎手术后老年患者满意度差的危险因素。
对 169 名 80 岁以上接受腰椎手术的患者进行了回顾性多中心调查。术后至少随访 1 年。我们通过新开发的患者问卷评估手术结果的患者满意度。患者根据人口统计学数据、手术程序、并发症、再次手术率、疼痛改善以及腰椎疾病手术患者满意度差的危险因素进行评估。
共有 131 名患者（77.5%，G 组）对手术满意，38 名患者（22.5%，P 组）对手术不满意。两组在基线特征和手术数据方面无显著差异。术后腰椎和腿痛的视觉模拟评分在 P 组明显高于 G 组（腰痛：G 组，1.7±1.9 vs. P 组，5.2±2.5，P<0.001；腿痛：G 组，1.4±2.0 vs. P 组，5.5±2.6，P<0.001）。多变量回归分析显示，术后椎体骨折（P=0.049；比值比，3.096；95%置信区间，1.004-9.547）和再次手术（P=0.025；比值比，5.692；95%置信区间，1.250-25.913）与腰椎手术后患者满意度显著相关。
术后椎体骨折和再次手术是老年患者腰椎手术后患者满意度差的危险因素，这表明在老年患者中，除了仔细确定手术适应证和手术方法外，还需要谨慎治疗骨质疏松症。
III 级。
