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Effect of age on clinical and radiographic outcomes and adverse events following 1-level lumbar arthroplasty after a minimum 2-year follow-up

OBJECT: Lumbar arthroplasty is approved in the US for the treatment of degenerative disc disease at 1 level in skeletally mature patients. However, a bias toward older patients (> 45 years of age) who are otherwise indicated for the procedure may exist. In this study, the clinical outcomes of patients from the Charite Investigational Device Exemption (IDE) study were analyzed on the basis of patient age. METHODS: There were 276 patients enrolled in the IDE study of the Charite Artificial Disc who underwent 1-level arthroplasty at either L4-5 or L5-S1, including 71 nonrandomized and 205 randomized individuals. Patient data were analyzed based on age (18-45 years [217 patients, Group 1] compared with 46-60 years [59 patients, Group 2]). Statistical analyses were performed based on 2-year postoperative improvements in Oswestry Disability Index (ODI), 36-item Short Form Health Survey (SF-36), and visual analog scale (VAS) scores (clinical outcome), as well as range of motion (radiographic outcome), and adverse events. RESULTS: There was no significant difference between the groups with respect to level implanted, operative time, blood loss, changes in ODI and VAS scores or any of the 8 component scores of the SF-36, compared with baseline, at all time points throughout the 24-month follow-up period (p > 0.10). Patient satisfaction was equivalent at 24 months, with 87% satisfaction in Group 1 and 85% satisfaction in Group 2 (no statistical difference). In addition, no significant differences were identified with respect to adverse events including approach related, neurological, technique related, or reoperation. CONCLUSIONS: Although patients > 45 years of age may have comorbidities or contraindications for arthroplasty for a number of reasons, particularly osteopenia, this analysis demonstrates that patients who are indicated for 1-level arthroplasty experience similar clinical outcome, satisfaction, or adverse events compared with their younger counterparts

Keywords : Adolescent,Adult,adverse effects,Age Factors,Arthroplasty,Arthroplasty,Replacement,Device Approval,diagnostic imaging,Female,Follow-Up Studies,Humans,instrumentation,Intervertebral Disc,Joint Prosthesis,Lumbar Vertebrae,methods,Middle Aged,Patient Satisfaction,Radiography,Reoperation,Spinal Diseases,surgery,Time Factors,Treatment Outcome,, Age,Clinical, posture correction london

Date of Publication : 2008 Feb

Authors : Guyer RD;Geisler FH;Blumenthal SL;McAfee PC;Mullin BB;

Organisation : Texas Back Institute, Plano, Texas, USA

Journal of Publication : J Neurosurg Spine

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/18248280

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