Abbas Zahir, Asati Sanjeev, Kundnani Vishal G, Jain Sanyam, Prakash Rahul, Raut Saijyot
Mumbai Institute of Spine Surgery, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, 400020, India.
J Clin Orthop Trauma. 2021 Mar 18;17:157-162. doi: 10.1016/j.jcot.2021.03.007. eCollection 2021 Jun.
Retrospective study.
To evaluate and compare the outcomes of single stage surgery for Tandem Spinal Stenosis (TSS) in elderly (Age ≥65 years) and younger patients (Age <65 years).
Tandem spinal stenosis among elderly is common and often missed diagnosed with delayed presentation. Literature evaluating efficacy and safety of single staged surgery for TSS in elderly patients is scanty.
Analysis of 74 patients with TSS managed with single stage posterior surgery from 2007 to 2016 was done. A total of 62 patients who satisfied our inclusion criteria were evaluated and subdivided into two groups based on age; Study group (age ≥65years)] (n = 32) and control group (age <65years) (n = 30). Perioperative, clinical/radiological parameters and postoperative complications and recovery rate were noted.
The Mean ODI and mJOA showed significant improvement post-operatively in both groups however there was no significant difference between the two groups at final follow-up. There was no statistical difference in operative time, blood loss and hospital stay between the groups. As per Odom's criteria, 78.1% had excellent to good results in study group, while 83.3% had excellent to good results in control group. Postoperative complications were more in elderly group however, there was no significant difference among neurological or cardiopulmonary complications between both groups.
Single stage surgery is safe & efficacious modality with less morbidity and optimal results in elderly patients with proper preoperative risk assessment. Our study showed that increased age does not proved to be deterrent in the outcome of single staged surgery in tandem spinal stenosis.
回顾性研究。
评估并比较老年患者(年龄≥65岁)和年轻患者(年龄<65岁)串联性椎管狭窄(TSS)一期手术的疗效。
老年患者中的串联性椎管狭窄很常见,常被漏诊且就诊延迟。评估老年患者TSS一期手术疗效和安全性的文献较少。
对2007年至2016年接受一期后路手术治疗的74例TSS患者进行分析。共有62例符合纳入标准的患者接受评估,并根据年龄分为两组;研究组(年龄≥65岁)(n = 32)和对照组(年龄<65岁)(n = 30)。记录围手术期、临床/放射学参数以及术后并发症和恢复率。
两组患者术后平均ODI和mJOA均有显著改善,但末次随访时两组间无显著差异。两组在手术时间、失血量和住院时间方面无统计学差异。根据奥多姆标准,研究组78.1%的患者结果为优至良,而对照组为83.3%。老年组术后并发症更多,然而两组间神经或心肺并发症无显著差异。
对于老年患者,一期手术是一种安全有效的方式,术前进行适当的风险评估可降低发病率并取得最佳效果。我们的研究表明,年龄增长并非串联性椎管狭窄一期手术疗效的阻碍因素。