Lumbar Arthrodesis Good Option for Older Patients

Improvements seen in most clinical and quality-of-life measures in older patients

12 april 2009-- In selected older patients with degenerative disc disease, single-level posterolateral lumbar arthrodesis with an iliac crest bone graft is a beneficial treatment, according to a study published in the April issue of the Journal of Bone & Joint Surgery.

Steven D. Glassman, M.D., of the Leatherman Spine Center in Louisville, Ky., and colleagues studied outcomes in 224 patients, including 174 who were younger than age 65, and 50 who were aged 65 and older.

After two years, the researchers found that older patients had greater mean improvements than young patients in the Oswestry Disability Index score (28.5 points versus 24.5 points) and the Short Form-36 physical component summary scores (14.2 points versus 11.7 points), and that older patients also had significantly greater improvements in leg pain scores (10.4 points versus 6.4 points).

"The present study revealed greater improvement in the older patients for virtually every clinical and health-related quality-of-life measure and at every time interval," the authors write. "While in many instances the differences were not significant, the pattern clearly demonstrates similar, if not better, outcomes in this older group of patients. In addition, these improvements occurred despite a higher rate of perioperative complications."

The study was supported by Medtronic Sofamor Danek; several authors disclosed a financial relationship with Medtronic.

Abstract
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