Spine · 2024
Should We Operate on Octogenarians With Cervical Myelopathy or Radiculopathy?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zakieh Omar, Jawid Maryam Y, Bowers Mitchell F, Young Mason W, Zuckerman Scott L, Lugo-Pico Julian G, Gardocki Raymond J, Abtahi Amir M, Stephens Byron F
Аннотация
STUDY DESIGN: Retrospective cohort.
OBJECTIVE: Investigate the disparities between octogenarians and nonoctogenarians undergoing cervical spine surgery regarding perioperative, and postoperative outcomes.
SUMMARY OF BACKGROUND DATA: As the population ages, the demand for elective cervical spine surgery among older, more active adults increases. However, concerns remain regarding the optimal management of older patients undergoing cervical surgery, given the potential complexities associated with advanced age, comorbidities, and physiological decline. While the safety and efficacy of cervical spine surgery in younger cohorts have been extensively studied, there is a paucity of literature specifically addressing outcomes in octogenarians.
MATERIALS AND METHODS: Octogenarians undergoing elective cervical spine surgery were propensity matched 3:1 to patients below 80 years old by baseline neck and arm pain, surgical approach, and total instrumented levels. Primary outcomes of interest were postoperative complications, unexpected 90-day hospital readmissions and 12-month reoperation. Secondary outcomes were 12-month patient satisfaction and patient-reported outcome measures (PROMs) at 3 and 12 months, including EuroQol-5D, modified Japanese Orthopaedic Association, neck disability index, and visual analog scale for neck and arm pain.
RESULTS: There were 29 octogenarians and 87 nonoctogenarians identified. The mean age in each cohort was 82.4±2.2 vs. 59.1±11.1 years, respectively. There was no difference in postoperative complications (10.3% vs. 6.9%, P =0.548), 90-day readmission (10.3% vs. 6.9%, P =0.548), and 12-month reoperation (3.4% vs. 2.3%, P =0.736) between octogenarians and nonoctogenarians. Similarly, octogenarians and nonoctogenarians experienced comparable 12-month patient satisfaction (65.2% vs. 55.3%, P =0.393), improvement in 3- and 12-month PROMs, and MCID achievement.
CONCLUSIONS: Postoperative complications, readmission, reoperation rate, patient satisfaction, and PROMs did not significantly differ between octogenarians and nonoctogenarians undergoing cervical spine surgery. These findings suggest that age alone should not be a determining factor in surgical decision-making for elective cervical spine procedures, as octogenarians can achieve comparable outcomes to their younger counterparts.
OBJECTIVE: Investigate the disparities between octogenarians and nonoctogenarians undergoing cervical spine surgery regarding perioperative, and postoperative outcomes.
SUMMARY OF BACKGROUND DATA: As the population ages, the demand for elective cervical spine surgery among older, more active adults increases. However, concerns remain regarding the optimal management of older patients undergoing cervical surgery, given the potential complexities associated with advanced age, comorbidities, and physiological decline. While the safety and efficacy of cervical spine surgery in younger cohorts have been extensively studied, there is a paucity of literature specifically addressing outcomes in octogenarians.
MATERIALS AND METHODS: Octogenarians undergoing elective cervical spine surgery were propensity matched 3:1 to patients below 80 years old by baseline neck and arm pain, surgical approach, and total instrumented levels. Primary outcomes of interest were postoperative complications, unexpected 90-day hospital readmissions and 12-month reoperation. Secondary outcomes were 12-month patient satisfaction and patient-reported outcome measures (PROMs) at 3 and 12 months, including EuroQol-5D, modified Japanese Orthopaedic Association, neck disability index, and visual analog scale for neck and arm pain.
RESULTS: There were 29 octogenarians and 87 nonoctogenarians identified. The mean age in each cohort was 82.4±2.2 vs. 59.1±11.1 years, respectively. There was no difference in postoperative complications (10.3% vs. 6.9%, P =0.548), 90-day readmission (10.3% vs. 6.9%, P =0.548), and 12-month reoperation (3.4% vs. 2.3%, P =0.736) between octogenarians and nonoctogenarians. Similarly, octogenarians and nonoctogenarians experienced comparable 12-month patient satisfaction (65.2% vs. 55.3%, P =0.393), improvement in 3- and 12-month PROMs, and MCID achievement.
CONCLUSIONS: Postoperative complications, readmission, reoperation rate, patient satisfaction, and PROMs did not significantly differ between octogenarians and nonoctogenarians undergoing cervical spine surgery. These findings suggest that age alone should not be a determining factor in surgical decision-making for elective cervical spine procedures, as octogenarians can achieve comparable outcomes to their younger counterparts.