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Long-Term Results of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Elderly Patients: A 5-Year Follow-Up Study – Lumbar Fusion

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This article is a retrospective review of prospective data that examines the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in elderly patients compared to younger controls. The study included 120 patients who underwent single-level MIS-TLIF for degenerative spondylolisthesis, with 30 patients in the elderly group (≥70 years) and 90 patients in the control group (<70 years). The results showed that elderly patients had a longer length of stay and more readmissions, but there were no significant differences in operative time, complications, or discharge disposition. Both groups achieved similar improvements in pain, disability, and quality of life at the 5-year follow-up. The study concludes that MIS-TLIF is beneficial for elderly patients, providing sustained improvements in outcomes. (Level of Evidence: Level III, retrospective cohort study) Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: Elderly patients undergoing MIS-TLIF achieved similar improvements in pain, disability and quality of life that were sustained at 5 years.Level of Evidence: Level III, retrospective cohort study.

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Global Spine J. 2023 Nov 9:21925682231214067. doi: 10.1177/21925682231214067. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective review of prospective data.OBJECTIVES: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger,

Global Spine J. 2023 Nov 9:21925682231214067. doi: 10.1177/21925682231214067. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective review of prospective data.

OBJECTIVES: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger controls at minimum 5-year follow-up.

METHODS: There were 120 patients who underwent single-level MIS-TLIF for degenerative spondylolisthesis. Elderly patients (≥70 years; n = 30) and controls (<70 years; n = 90) were matched 1:3 for demographics, comorbidities and preoperative patient-reported outcomes (PROs). The Oswestry Disability Index (ODI), 36-Item Short-Form Physical (SF-36 PCS) and Mental Component Summary (SF-36 MCS), Visual Analogue Scale (VAS) back pain, and VAS leg pain were compared at 6 months, 2 years and 5 years. Radiographic fusion, adjacent segment degeneration (ASD) and revision rates were assessed at mean 7.2 ± 2.0 years.

RESULTS: Elderly patients had longer length of stay (4.7 ± 5.8 vs 3.3 ± 1.4 days, P = .035) and more readmissions (10% vs 1%, P = .019), but there was no difference in operative time, transfusions, complications or discharge disposition. All PROs were comparable at 5 years and satisfaction rates were similar (93% elderly vs 91% controls, P = .703). The rates of radiographic fusion in the control group and elderly group were similar (94% vs 97%, P = .605), as were the rates of ASD (40% vs 33%, P = .503). There were 3 revisions (3.3%) in the control group (2 for ASD, 1 for screw loosening) but none in the elderly group (P = .311).

S: Elderly patients undergoing MIS-TLIF achieved similar improvements in pain, disability and quality of life that were sustained at 5 years.Level of Evidence: Level III, retrospective cohort study.

PMID:37942769 | DOI:10.1177/21925682231214067

The London Spine Unit : innovative spinal clinic in UK

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Long-Term Results of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Elderly Patients: A 5-Year Follow-Up Study

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Global Spine J. 2023 Nov 9:21925682231214067. doi: 10.1177/21925682231214067. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective review of prospective data.OBJECTIVES: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger
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