MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION IN GERIATRIC PATIENTS

• Published in: The journal of Turkish spinal surgery 2022-01, Vol.33 (1), p.23-29
• Main Authors: Büyük, Abdul Fettah, Shafa, Eiman, Dawson, John M., Gaffney, Christian J., Schwender, James D.
• Format: Article
• Language: English
• Subjects: Age; Back pain; Back surgery; Body mass index; Cardiovascular disease; Clinical outcomes; Coronary vessels; Hospitalization; Minimally invasive surgery; Older people; Patients; Population; Quality of life; Skin; Vein & artery diseases
• ISSN: 1301-0336; 2147-5903
• DOI: 10.4274/jtss.galenos.2022.22931

Objective: Several studies report that spine surgery in elderly patients (>65 years old) is associated with higher reoperation and complication rates. Although transforaminal lumbar interbody fusion (TLIF) in elderly patients can result in lower clinical improvement and higher complication rates, minimally invasive surgery (MIS) TLIF has potential advantages. We compared clinical outcomes and complication rates after MIS TLIF with pedicle screw fixation in younger and older geriatric patients (those aged 65 to 74 years compared to those aged 75 to 85 years). Materials and Methods: This was a retrospective cohort study of patients with lumbar degenerative spondylolisthesis. Patients were divided into those between 65 and 74 years old (n=45) and those between 75 and 84 (n=23). Patients had two-year follow-up. Results: Older geriatric patients (between 75 and 84 years old) had 1.3 times as many comorbidities as the younger patients, but the difference was not statistically significant. Surgery was significantly longer in the older cohort, but there were no significant differences in intraoperative complications. There were no differences in complication rates during postoperative hospitalization or within 30 days after discharge. No significant differences in complication rates were noted at 6 or 24 months after discharge. There were no differences in patient reported outcomes. Minimum clinically important differences in patient reported outcomes were the same between cohorts at last reported outcome. Conclusion: The MIS TLIF with pedicle screw fixation for degenerative spondylolisthesis is as safe and effective in older geriatric patients as in younger ones.