Chernysh Alexander A, Leyendecker Jannik, Leary Owen P, Sastry Rahul A, Gokaslan Ziya L, Fridley Jared S, Derman Peter, Kashlan Osama, Konakondla Sanjay, Ogunlade John, Hofstetter Christoph P, Telfeian Albert E
Department of Neurosurgery, Warren Alpert Medical School, Brown University, Providence, RI, USA
Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
Int J Spine Surg. 2025 Mar 6;19(1):27-38. doi: 10.14444/8693.
Full endoscopic spine surgery (FESS) champions a rapid recovery and a low rate of overall complications. However, its efficacy in geriatric patients that might yield additional benefits from minimized invasiveness remains underexplored.
A multi-institutional prospective cohort study was conducted involving patients undergoing elective lumbar FESS. Participants were categorized into nongeriatric (18-69 years old) and geriatric (≥70 years old) groups. Studied variables included demographics, medical comorbidities, operative details, visual analog scale (VAS) for back and leg pain, and Oswestry Disability Index (ODI). A mobile application was leveraged to collect real-time data pre- and postoperatively.
One hundred and sixty-four patients were included and divided into nongeriatric ( = 125) and geriatric ( = 39) cohorts. No group differences were observed between sex ( = 0.404), body mass index ( = 0.372), procedure duration ( = 0.350), or blood loss ( = 0.384). Nongeriatric patients received discectomy more frequently ( < 0.001), while older patients underwent more decompressive procedures ( < 0.001). Characterization of pain and functional outcome revealed that nongeriatric and geriatric patients follow a similar recovery trajectory and both appreciate significant improvements from baseline to 3 months postoperatively ( < 0.001 for VAS back, VAS leg, and ODI). There were no differences in the rate of improvement between age groups at any time point ( > 0.05 for VAS back, VAS leg, and ODI).
FESS significantly improves pain and function in both geriatric and nongeriatric adults with degenerative lumbar conditions, with no difference in the degree of improvement between groups.
These findings underscore the efficacy of FESS as a minimally invasive surgical option for elderly patients. Mobile application technology is useful for collecting patient-reported data in spine surgery clinical research.
全内镜脊柱手术（FESS）支持快速康复且总体并发症发生率低。然而，其在老年患者中的疗效尚未得到充分探索，而老年患者可能会从微创中获得额外益处。
进行了一项多机构前瞻性队列研究，纳入接受择期腰椎FESS的患者。参与者被分为非老年组（18 - 69岁）和老年组（≥70岁）。研究变量包括人口统计学、合并症、手术细节、背部和腿部疼痛的视觉模拟量表（VAS）以及Oswestry功能障碍指数（ODI）。利用移动应用程序收集术前和术后的实时数据。
共纳入164例患者，分为非老年组（n = 125）和老年组（n = 39）队列。在性别（P = 0.404）、体重指数（P = 0.372）、手术时长（P = 0.350）或失血量（P = 0.384）方面未观察到组间差异。非老年患者更频繁地接受椎间盘切除术（P < 0.001），而老年患者接受更多减压手术（P < 0.001）。疼痛和功能结果的特征表明，非老年和老年患者遵循相似的恢复轨迹，且从基线到术后3个月均有显著改善（VAS背部、VAS腿部和ODI的P < 0.001）。在任何时间点，年龄组之间的改善率均无差异（VAS背部 VAS腿部和ODI的P > 0.05）。
FESS显著改善了患有退行性腰椎疾病的老年和非老年成年人的疼痛和功能，两组之间的改善程度无差异。临床意义：这些发现强调了FESS作为老年患者微创外科手术选择的疗效。移动应用技术有助于在脊柱手术临床研究中收集患者报告的数据。
