BACKGROUND: We are aware of no reports on the surgical results of
posterior lumbar interbody fusion in elderly patients. The purpose of this
study was to investigate the clinical and radiographic results of posterior
lumbar interbody fusion with pedicle screws in patients older than seventy
years of age and compare them with results in younger patients. We also
investigated the association between the clinical and radiographic
METHODS: The study included 101 patients who had been followed for
at least three years after posterior lumbar interbody fusion with pedicle
screws for the treatment of L4-L5 degenerative spondylolisthesis. The average
follow-up period was fifty months. The patients were divided into two groups
according to their age at the time of the operation: Group 1 included
thirty-one patients who were seventy years of age or older (average age,
seventy-four years) at the time of the operation, and Group 2 included seventy
patients who were less than seventy years old (average age, fifty-nine years).
Preoperative and postoperative status (according to the Japanese Orthopaedic
Association scoring system) and postoperative complications were compared
between the two groups. Postoperative radiographic features, including fusion
status and segmental lordosis, were also examined.
RESULTS: No significant differences in preoperative and
postoperative scores were observed between the two age groups, with the
numbers available. General complications were found in Group 1. However, the
prevalence of adjacent segment degeneration in Group 1 was lower than that in
Group 2. The radiographic results revealed no significant difference in the
prevalence of segmental lordosis, with the numbers available. There was no
nonunion in either group. Although the prevalence of either collapsed union or
delayed union in Group 1 was significantly higher than that in Group 2 (p =
0.034), the fusion results such as union in situ, collapsed union, and delayed
union did not appear to affect the postoperative clinical results in this
CONCLUSIONS: No obvious differences in the clinical results were
observed between the age groups with the numbers available. Postoperative
adjacent segment degeneration was less frequent and collapsed union and
delayed union were more common in the elderly group. The fusion results did
not appear to affect the postoperative clinical results in this study.
LEVEL OF EVIDENCE: Prognostic Level II. See Instructions
to Authors for a complete description of levels of evidence.
ORIGINAL ABSTRACT CITATION: "Surgical Outcomes of Posterior Lumbar
Interbody Fusion in Elderly Patients"