Our Summary

This research paper is a comparison of results from a particular type of back surgery, known as lateral lumbar interbody fusion (LLIF), in patients under 80 years old and those over 80. The study involved 102 patients, 92 of whom were under 80 and 10 were over 80. The patients’ back pain, leg pain, and leg numbness were evaluated before and after the surgery.

The results showed that patients over 80 years old had longer hospital stays and experienced more muscle weakness and injuries to the endplates (part of the spinal vertebra) after the surgery. However, regardless of age, all patients did see significant improvements in their pain and numbness after the surgery.

Interestingly, patients under the age of 80 showed an increase in the curvature of their lower back (lumbar lordosis) after the surgery, while this did not change for those over 80. This suggests that the surgery might have different effects on spinal alignment depending on the age of the patient.

The main takeaway from this study is that while there are some differences in recovery and outcomes, both age groups benefited from the surgery. Therefore, the researchers concluded that age alone shouldn’t be a reason to prevent older people from getting this surgery.

FAQs

  1. What is lateral lumbar interbody fusion (LLIF) and who were the patients in this study?
  2. How did the results of the LLIF surgery differ between patients under 80 and those over 80?
  3. Should age be a deciding factor for undergoing lateral lumbar interbody fusion surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to follow a rehabilitation program after surgery to strengthen the muscles around the spine and improve flexibility. This can help prevent future back problems and improve overall function and quality of life. Additionally, maintaining a healthy weight and staying active can also help support the healing process and reduce the risk of complications. It’s important to follow your doctor’s recommendations and attend follow-up appointments to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended lumbar fusion are those who have tried conservative treatments such as physical therapy, medications, and injections, but continue to experience chronic back pain, leg pain, or numbness due to conditions such as degenerative disc disease, spondylolisthesis, spinal stenosis, or spinal fractures. Additionally, patients with conditions that cause instability in the spine or deformities may also be candidates for lumbar fusion. It is important for patients to undergo a thorough evaluation by a spine specialist to determine if lumbar fusion is the right treatment option for their specific condition.

Timeline

Before lumbar fusion surgery:

  • Patient experiences chronic back pain, leg pain, and leg numbness
  • Patient undergoes evaluations, diagnostic tests, and consultations with a spine surgeon
  • Patient may try conservative treatments such as physical therapy, medications, and injections to alleviate symptoms

After lumbar fusion surgery:

  • Patient undergoes surgery to fuse the affected vertebrae in the lumbar spine
  • Patient may experience muscle weakness, discomfort, and restricted mobility immediately after surgery
  • Patient is hospitalized for a few days for monitoring and pain management
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Over time, patient experiences improvement in back pain, leg pain, and leg numbness
  • Patient may need to follow up with the surgeon for post-operative care and monitoring of recovery progress

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion, especially if they are over 80 years old, may include:

  1. What are the potential risks and complications associated with lumbar fusion surgery for someone my age?
  2. How does age affect the recovery process and long-term outcomes of lumbar fusion surgery?
  3. Are there any specific considerations or modifications that need to be made to the surgical approach or post-operative care for older patients?
  4. Will my age impact the likelihood of achieving pain relief and improved function after lumbar fusion surgery?
  5. Are there alternative treatment options that may be more suitable for older patients with similar spinal conditions?
  6. How will my age impact the management of pain and rehabilitation following lumbar fusion surgery?
  7. What is the expected timeline for recovery and return to normal activities for someone my age?
  8. Can you provide information on the success rates of lumbar fusion surgery in older patients compared to younger patients?
  9. How will my age impact the risk of complications such as muscle weakness or endplate injuries following lumbar fusion surgery?
  10. Are there any additional precautions or considerations that I should be aware of before undergoing lumbar fusion surgery at my age?

Reference

Authors: Hiyama A, Katoh H, Nomura S, Sakai D, Sato M, Watanabe M. Journal: World Neurosurg. 2022 Nov;167:e747-e756. doi: 10.1016/j.wneu.2022.08.078. Epub 2022 Aug 25. PMID: 36030011