Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology

Alexander A Chernysh; Jannik Leyendecker; Owen P Leary; Rahul A Sastry; Ziya L Gokaslan; Jared S Fridley; Peter Derman; Osama Kashlan; Sanjay Konakondla; John Ogunlade; Christoph P Hofstetter; Albert E Telfeian

doi:10.14444/8693

Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology

Int J Spine Surg. 2024 Dec 17:8693. doi: 10.14444/8693. Online ahead of print.

Authors

Affiliations

¹ Department of Neurosurgery, Warren Alpert Medical School, Brown University, Providence, RI, USA alexander.a.chernysh@gmail.com.
² Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
³ Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁴ Department of Neurosurgery, Warren Alpert Medical School, Brown University, Providence, RI, USA.
⁵ Department of Orthopedic Spine Surgery, Texas Back Institute, Plano, TX, USA.
⁶ Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
⁷ Department of Neurosurgery, Geisinger Neuroscience Institute, Danville, PA, USA.
⁸ Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA.

^# Contributed equally.

PMID: 39689970
DOI: 10.14444/8693

Abstract

Background: Full endoscopic spine surgery (FESS) champions a rapid recovery and a low rate of overall complications. However, its efficacy in geriatric patients that might yield additional benefits from minimized invasiveness remains underexplored.

Methods: A multi-institutional prospective cohort study was conducted involving patients undergoing elective lumbar FESS. Participants were categorized into nongeriatric (18-69 years old) and geriatric (≥70 years old) groups. Studied variables included demographics, medical comorbidities, operative details, visual analog scale (VAS) for back and leg pain, and Oswestry Disability Index (ODI). A mobile application was leveraged to collect real-time data pre- and postoperatively.

Results: One hundred and sixty-four patients were included and divided into nongeriatric (N = 125) and geriatric (N = 39) cohorts. No group differences were observed between sex (P = 0.404), body mass index (P = 0.372), procedure duration (P = 0.350), or blood loss (P = 0.384). Nongeriatric patients received discectomy more frequently (P < 0.001), while older patients underwent more decompressive procedures (P < 0.001). Characterization of pain and functional outcome revealed that nongeriatric and geriatric patients follow a similar recovery trajectory and both appreciate significant improvements from baseline to 3 months postoperatively (P < 0.001 for VAS back, VAS leg, and ODI). There were no differences in the rate of improvement between age groups at any time point (P > 0.05 for VAS back, VAS leg, and ODI).

Conclusions: FESS significantly improves pain and function in both geriatric and nongeriatric adults with degenerative lumbar conditions, with no difference in the degree of improvement between groups.

Clinical relevance: These findings underscore the efficacy of FESS as a minimally invasive surgical option for elderly patients. Mobile application technology is useful for collecting patient-reported data in spine surgery clinical research.

Keywords: aged; minimally invasive surgical procedures; patient reported outcome measures; spine; spondylosis.

This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2024 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.