Introduction: Lumbar decompression with an instrumented posterior fusion is an accepted surgical procedure for patients with symptomatic degenerative spondylolisthesis with stenosis. Numerous studies have demonstrated that advancing age is associated with increased hospital stay as well as complication rates. No long term studies have evaluated the use of spinous process(SP) hardware fixation for this condition in patients over the age of 55 years old.
Methods: A prospective, non-radomized cohort study. 44 consecutive patients underwent a posterior fusion with spinous process fixation at a single center by a single surgeon. Clinical measures were prospectively collected and evaluated to assess surgical details, complications, and outcome scores. Independent review of demographic, intraoperative, and post-operative data was performed. Oswestry disability index (ODI) and SF-36 values were prospectively collected pre-operatively and at 2 years post-operatively. Patients were broken into 3 age groups (55-64, n=7, 65-74, n=17, and >74, n=20) to assess differences in outcome.
Results: The mean age was 72.23 SD 7.03. The mean operating room time was 113.28 min, the mean hospital stay was 27.89 hours, and the average blood loss was 40cc. The changes in the ODI and SF36 scores demonstrated improvement across all time points. Between the three age groups, there was no statistical difference for OR time, hospital stay, ODI, or SF 36.
Conclusions: The use of SP for posterior lumbar fusion procedures is associated with a shorter operative and hospitalization times with improvement in the ODI and SF36 scores. Our study demonstrates that advancing age is not necessarily associated with increased length of hospital stay and complications in patients undergoing posterior lumbar instrumented fusion for degenerative spondylolisthesis with stenosis.
Patient Care: By demonstrating how the benefits of lumbar fusion with instrumentation remains consistent across multiple age groups.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Recognize the consistent clinical benefits across multiple age groups for patients who have undergone lumbar fusion with SP fixation.