Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Elderly

Objective The purpose of this study was to compare the clinical-radiological outcome and incidence of perioperative complications of MIS-TLIF at lower lumbar levels for elderly (Age >65 years) and younger patients (Age<65 years). Methods A retrospective cohort study performed from 2011 to 2017. A total 138 patients who underwent MIS-TLIF were divided into two groups based on age (group A>65 years and group B<65 years). Perioperative clinical (co-morbidities, surgical time, blood loss, hospital stay, fusion level, VAS, ODI), radiological parameters (fusion, cage subsidence, implant failure), postoperative complications and satisfactory outcomes in the form of Wang’s criteria were evaluated in both the groups. A statistical analysis between two matched groups was done with logistic regression analysis, chi-square and student t-test. Results There was no statistical difference in blood loss, surgical time, mobilization and hospital stay between two groups however elderly patients took longer time to become pain free (p=0.001). Both groups showed significant improvement in ODI, VAS and Wang’s outcome score however, no statistically significant difference noted in outcome between two groups at final follow up. General complications not affecting outcome were common in elderly group but no statistically significant difference noted among neurological events between both groups. Conclusion MISS-TLIF surgery in elderly can produce successful clinical outcome and satisfaction after surgery in judiciously selected patients with proper preoperative risk assessment and optimization of medical co-morbidities. Elder age does not prove deterrent to outcome and should not be a contraindication to perform MISS-TLIF in lumbar degenerative diseases.

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