Treatment of Lumbar Degenerative Disease by Lateral Lumbar Interbody Fusion in Patients Under and Over 80 Years of Age

Abstract

The purpose of this study was to compare clinical and radiological results of lateral lumbar interbody fusion (LLIF) for lumbar degenerative disease in patients under the age of 80years with those over the age of 80years. One hundred two patients who underwent LLIF without direct decompression were enrolled, including 92 patients who were less than 80years (group A) and 10 over 80years (group B). All patients were evaluated using numerical evaluation scale scores for low back pain, leg pain, and leg numbness, as well as demographic data, surgical data, and imaging data before and after LLIF surgery. Patients over the age of 80 years were found to have longer hospital stays (P= 0.006) and more postoperative muscle weakness (P= 0.011) and endplate injuries (P= 0.038). In addition, each numerical evaluation scale score improved significantly from preoperative to postoperative (P < 0.001). However, the changes in scores between preoperative and postoperative for each numerical evaluation scale were not significantly different between the 2 groups. Statistically significant increases in lumbar lordosis preoperatively compared with postoperatively were observed in patients under 80years but did not change in those over 80years. These data suggest a need for awareness of intraoperative endplate injury and postoperative motor weakness. Critically, indirect decompression with LLIF in lumbar degenerative disease in patients over age 80 as well as those under age 80 has shown satisfactory clinical and radiological results. This study shows that age alone should not prevent older people from undergoing LLIF.