Clinical Outcome of OLIF with Percutaneous Posterior Fixation in Lateral Position for Degenerative Spondylolisthesis: Comparison between Elderly and Non-elderly Patients

Presented at SMISS Annual Forum 2018
By Y. Koike
With Yoshihisa Kotani MD, PhD, H. Terao , Y. Hosokawa , H. Kobayasi , Yusuke Kameda , Hideaki Fukaya ,

Disclosures: Y. Koike None Yoshihisa Kotani MD, PhD B; L&K Biomed. , H. Terao None, Y. Hosokawa None, H. Kobayasi None, Yusuke Kameda None, Hideaki Fukaya None,

Introduction:

The recent progress of medical science has extended the average life span. The elderly people living with multiple comorbidities have increased chances of receiving the spinal surgery. We have performed oblique lumbar interbody fusion with percutaneous posterior fixation in lateral position (OLIF-LPF) for the surgical treatment of lumbar degenerative spondylolisthesis (DS) to minimize surgical invasiveness and complications for elderly population.

Aims/Objectives:

The purpose of this study was to investigate the clinical outcome of OLIF-LPF for elderly patients with single-level DS when compared to that in non-elderly patients.

Methods:

A total of 42 patients were enrolled in this study. We categorized patients into two groups: elderly patients (≥75 years of age: group E, n=24) and non-elderly patients (<75 years of age: group N, n=18). The mean ages were 79.6 years (range, 75-85 years) in group E and 63.0 years (range, 29-74 years) in group N, respectively. We evaluated operation time, estimated blood loss (EBL), postoperative laboratory data, overall functional outcome by Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) effective rate, and Visual Analogue Scale (VAS) of low back and leg pain.

Results:

Mean follow-up period was 26.0 months (16-43 months). No statistical differences in terms of operation time, EBL and laboratory data were observed. Both groups showed improvement in clinical outcome scores of all domains in JOABPEQ postoperatively, however the effective rate in lumbar function tended to be higher in group E (52.9) than in group N (20.0) (p=0.055). In both groups, the postoperative VAS scores revealed significant improvement compared with the preoperative values in all items (p<0.05). There were no statistical differences between two groups in terms of pre- and post-operative VAS score change.

Conclusions:

The clinical outcome of OLIF-LPF in elderly patients was equivalent to that in non-elderly patients. The OLIF-LPF was serving as minimally invasive surgical procedure with small EBL and less back muscle injury. There are many advantages in lateral procedure in which the prone position surgery can be avoided in elderly patients with cardiovascular and respiratory comorbidities.