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25-09-2024 | Scoliosis | Original Paper

Clinical outcomes of percutaneous transforaminal endoscopic decompression for the treatment of degenerative lumbar scoliosis associated with spinal stenosis in elderly individuals: a matched comparison study

Authors: Ning Fan, He Song, Lei Zang, Aobo Wang, Tianyi Wang, Shuo Yuan, Peng Du, Qichao Wu

Published in: International Orthopaedics

Abstract

Purpose

This retrospective cohort study evaluated the efficacy and safety of percutaneous transforaminal endoscopic decompression (PTED) in elderly patients with degenerative lumbar scoliosis (DLS) associated with lumbar spinal stenosis (LSS).

Study design

A matched comparison study.

Methods

In total, 97 patients with DLS associated with LSS who underwent PTED under local anesthesia between 2016 and 2021 were retrospectively analyzed. Using the inclusion and exclusion criteria, 24 patients aged ≥ 80 years were screened and included in the study group. Then, 24 patients aged 50–80 years were matched according to gender, date of surgery, and surgical levels were included in the control group. Clinical outcomes such as the visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, modified MacNab criteria, radiological parameters, and complications were assessed. The independent sample t-test, Pearson’s chi-square test and Fisher’s exact test were used to compare the parameters between the study and control groups.

Results

The study group had significantly higher mean American Society of Anesthesiologists classification and age-adjusted Charlson Comorbidity Index scores than the control group (2.42 ± 0.72) vs. 5.25 ± 1.03 and 1.67 ± 0.76 vs. 3.17 ± 2.10, respectively). The VAS scores for pain in two legs and back and ODI scores significantly improved at two weeks after surgery and at the final followup (p < 0.05). The study group had higher back pain VAS and ODI scores than the control group at the final followup (p < 0.05). In addition, the complication and patient satisfaction rates were similar between the two groups (p > 0.05). The overall radiological parameters were comparable between the two groups, and there was no significant deterioration in coronal imbalance or loss of disc height between the two groups.

Conclusion

Elderly patients (aged ≥ 80 years) with DLS associated with LSS are less fit and have a greater number of comorbidities. However, they can achieve satisfactory outcomes with PTED, which are comparable to those of patients < 80 years. PTED under local anesthesia can also be an efficient alternative to conventional open lumbar decompression surgery for treating elderly patients with comorbidities.

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Title: Clinical outcomes of percutaneous transforaminal endoscopic decompression for the treatment of degenerative lumbar scoliosis associated with spinal stenosis in elderly individuals: a matched comparison study
Authors: Ning Fan
He Song
Lei Zang
Aobo Wang
Tianyi Wang
Shuo Yuan
Peng Du
Qichao Wu
Publication date: 25-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Scoliosis
Spinal Stenosis
Back Pain
Back Pain
Back Pain
Published in: International Orthopaedics
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-024-06318-x

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Clinical outcomes of percutaneous transforaminal endoscopic decompression for the treatment of degenerative lumbar scoliosis associated with spinal stenosis in elderly individuals: a matched comparison study

Abstract

Purpose

Study design

Methods

Results

Conclusion

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Purpose

Study design

Methods

Results

Conclusion

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