Should age be a contraindication for degenerative lumbar surgery?

Abstract

The purpose of this study was to evaluate and compare disability, quality of life and satisfaction outcomes between young people and elderly who were operated on for degenerative lumbar disease. A database of 263 patients undergoing lumbar surgery for degenerative conditions was collected. There were 74 patients who were 65years old or above and 189 who were below 65who had complete preoperative and 2-year postoperative HRQOL data measures: ODI, SF-36 and COMI. There were no significant differences in the outcomes between the two age groups (p>0.05). An improvement from baseline in all quality of life measures in the two age groups was observed. A median improvement of 6.0 points was found in the ODI in the younger patients versus 12.0 in older ones. A median improvement in the SF36 physical component score of 6.95 was seen in the younger group while improvement was reported at 6.36 points in patients over 65. The SF36 mental component score improved by 4.48 points and 4.96 points, respectively. COMI improved a median of 1.2 points in both groups. In terms of satisfaction, 66.9% of the younger patients were pleased or very pleased whereas this was found to be 59.7% for the older group. Older patients can see substantial clinical improvement after degenerative lumbar disease surgery similar to that obtained in younger patients in terms of quality of life and satisfaction. The improvement in terms of the disability is greater for older patients. Thus, age should not be a contraindication for this procedure.