Clinical outcome of percutaneous endoscopic lumbar decompression in treatment of elderly patients with lumbar spinal stenosis: a matched retrospective study

• Published in: International orthopaedics 2024, Vol.48 (1), p.201-209
• Main Authors: Wang, Lei, Wang, Tianyi, Fan, Ning, Yuan, Shuo, Du, Peng, Si, Fangda, Wang, Aobo, Zang, Lei
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Back Pain - etiology; Constriction, Pathologic - complications; Constriction, Pathologic - surgery; Decompression, Surgical - adverse effects; Humans; Lordosis - complications; Lordosis - surgery; Lumbar Vertebrae - surgery; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Retrospective Studies; Spinal Stenosis - complications; Spinal Stenosis - surgery; Treatment Outcome
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-023-05947-y

Purpose This retrospective cohort study aimed to evaluate the efficacy and safety of percutaneous endoscopic lumbar decompression (PELD) in elderly patients with lumbar spinal stenosis (LSS). Study Design A matched retrospective study. Setting The research was conducted in Beijing Chaoyang Hospital, Capital Medical University, China. Methods This study included patients treated with PELD for LSS from September 2016 to September 2020. Patients with LSS aged ≥ 80 years were screened according to the inclusion and exclusion criteria as the study group, and then the same number of patients with LSS aged 50–80 years were matched according to gender, stenosis type, and surgical segment as the control group. Preoperative patient status was assessed using the Charlson comorbidity index (CCI) and the American Society of Anesthesiologists (ASA) physical status classification score. Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry Disability Index (ODI) scores, modified Macnab criteria, radiological parameters and complication rates. Results A total of 624 LSS patients met the screening criteria between September 2016 and September 2020, with 47 LSS patients ≥ 80 years old serving as the study group. Forty-seven LSS patients aged 50–80 years were matched to the study group according to gender, stenosis type, and stenosis segment. The CCI score (1.77 ± 1.67) and ASA classification (2.62 ± 0.74) of the study group were significantly higher than the CCI score (0.66 ± 0.96) and ASA classification (1.28 ± 0.54) of the control group, and the difference was statistically significant. Compared with preoperative data, postoperative ODI, leg pain VAS scores and back pain VAS scores were significantly improved in both groups ( p   0.05). The operation time and postoperative hospital stay in control group were significantly lower than those in study ( p   0.05). Besides, overall radiological parameters were comparable in elder and younger patients ( p  > 0.05), and disc height (DH), lumbar lordosis and segmental lordosis decreased after two year follow-up in both groups ( p   0.05), and no serious complications and dea