As the number of Americans age 80 and older continues to rise, so does the percentage of patients with acute spinal conditions. A new study appearing in the Journal of Bone and Joint Surgery (JBJS) found significant benefit from surgical treatment for lumbar spinal stenosis with and without degenerative spondylolisthesis–debilitating spinal conditions causing leg and back pain, numbness and weakness–and no higher overall complication rate and no higher mortality for patients age 80 and older when compared to patients younger than age 80.
Between 2000 and 2010 the U.S. population age 80 and older increased 22 percent to 11.2 million, and approximately 47 percent of Americans age 60 and older have spinal stenosis, a narrowing of the spinal canal due to the wear and tear associated with aging.
In this study, researchers reviewed Spine Patient Outcomes Research Trial (SPORT) data for 105 patients, age 80 and older, and 1,130 patients younger than age 80 with lumbar stenosis alone or combined with degenerative spondylolisthesis. Patient clinical characteristics, including age, sex, ethnicity, college and work status, body mass index (BMI), smoking, comorbidities, level of back and leg pain, self-assessment of general health and treatment preference, were reviewed at baseline. Levels of pain, assessment of general health, complications, the need for revision surgery, and mortality were measured postoperatively for up to four years.
“This study demonstrates that surgery for the treatment of lumbar stenosis and degenerative spondylolisthesis provides significant benefit compared to nonoperative treatment in those patients over the age of 80,” said lead study author Jeffrey A. Rihn, MD, an orthopaedic surgeon at the Rothman Institute and associate professor at Thomas Jefferson University Hospital in Philadelphia, Pa. “Patients in this age group had significant improvement in their function after surgery and complication rates comparable to the younger demographic. Based on the results of this study, surgery should be considered a viable treatment option for these lumbar conditions in patients older than age 80. Future studies are needed to better assess the cost-effectiveness of surgery in this patient population.”
Reserving claim files for life time medical awards will be more accurate if studies such as this one are taken into account.