Efficacy and Safety of Biportal Endoscopic Decompressive Laminectomy in Octogenarians With Severe Lumbar Spinal Stenosis.

IF 1.7 Q2 SURGERY International Journal of Spine Surgery Pub Date : 2024-10-04 DOI:10.14444/8649
Sang-Min Park, John I Shin, Jin-Ho Park, Jonghun Jung, Jiwon Park, Ho-Joong Kim, Jin S Yeom, Hyun-Jin Park
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Abstract

Background: Lumbar spinal stenosis (LSS) is prevalent among octogenarians, causing significant pain and disability. Surgical intervention is often required because of the ineffectiveness of conservative treatments. This study investigates the efficacy and safety of biportal endoscopic decompressive laminectomy (BED) in octogenarians with severe LSS, evaluating its potential as a minimally invasive surgical option.

Methods: This retrospective study included 107 patients aged 80 years or older who underwent BED for LSS between March 2017 and December 2022. Data were collected from electronic medical records, including demographic information, clinical outcomes, and surgical details. Patients with fractures, infectious spondylitis, herniated discs, and follow-up less than 12 months were excluded. Clinical outcomes were assessed using the visual analog scale, Oswestry Disability Index, European Quality of Life-5 Dimensions, and painDETECT at baseline and at 3, 6, and 12 months after surgery.

Results: The mean age of the 107 patients was 84.1 years, with 59% being women. Significant improvements were observed in visual analog scale scores for lower back and lower extremities pain, Oswestry Disability Index, European Quality of Life-5 Dimensions, and painDETECT scores, indicating reduced pain, decreased disability, and enhanced quality of life. There were no significant differences in outcomes between patients aged 80 to 84 and those 85 or older. Surgery-related outcomes such as operation time, blood loss, and complications were similar in both age groups.

Conclusions: BED is a safe and effective treatment for LSS in octogenarians, providing significant pain relief and functional improvement. This minimally invasive technique is also viable for patients older than 85 years, without increased risk of complications, supporting its broader indications in managing LSS in the elderly.

Clinical relevance: This study highlights the efficacy and safety of BED for LSS in octogenarians, demonstrating its potential to improve quality of life and function with low risks, making it a feasible option for elderly patients.

Level of evidence: 4:

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双门内窥镜减压椎板切除术对八高龄重度腰椎管狭窄症患者的有效性和安全性
背景:腰椎管狭窄症(LSS)在八旬老人中很普遍,会导致严重的疼痛和残疾。由于保守治疗效果不佳,通常需要手术干预。本研究探讨了双皮质内镜下椎板减压切除术(BED)对八旬重度椎管狭窄症患者的疗效和安全性,评估了其作为微创手术选择的潜力:这项回顾性研究纳入了2017年3月至2022年12月期间接受BED治疗LSS的107名80岁或80岁以上的患者。数据来自电子病历,包括人口统计学信息、临床结果和手术细节。排除了骨折、感染性脊柱炎、椎间盘突出以及随访不足12个月的患者。临床结果采用视觉模拟量表、Oswestry残疾指数、欧洲生活质量-5维度和疼痛DETECT进行评估,评估时间为基线和术后3、6、12个月:107 名患者的平均年龄为 84.1 岁,其中 59% 为女性。下背部和下肢疼痛的视觉模拟量表评分、Oswestry残疾指数、欧洲生活质量-5维度和painDETECT评分均有明显改善,表明疼痛减轻、残疾减少和生活质量提高。80 至 84 岁的患者与 85 岁或以上的患者在治疗效果上没有明显差异。两个年龄组的手术相关结果,如手术时间、失血量和并发症等都相似:BED是治疗八旬老人LSS的一种安全有效的方法,能明显缓解疼痛并改善功能。这种微创技术对 85 岁以上的患者也是可行的,不会增加并发症风险,支持其在治疗老年 LSS 方面更广泛的适应症:本研究强调了 BED 治疗八旬老人 LSS 的有效性和安全性,证明了其改善生活质量和功能的潜力,且风险较低,是老年患者的可行选择:4:
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
162
期刊介绍: The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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