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Journal of Neurosurgical Sciences 2017 Jul 10

DOI: 10.23736/S0390-5616.17.03977-7


lingua: Inglese

Which functional outcome parameters correlate better with elderly patients’ satisfaction after non-fusion lumbar spine surgery?

Triantafyllos BOURAS 1 , Fahed ZAIRI 2, Maria LOUFARDAKI 3, Michel TRIFFAUX 1, George STRANJALIS 3, 4

1 Department of Neurosurgery, CHWAPI, Tournai, Belgium; 2 Department of Neurosurgery, Roger Salengro Hospital, CHRU Lille, France; 3 Hellenic Center of Neurosurgical Research “Professor Petros Kokkalis”, Athens, Greece; 4 Department of Neurosurgery, Evangelismos Hospital, University of Athens, Greece


BACKGROUND: Elderly patients are increasingly operated for spinal degenerative diseases. The treatment objective is quality of life, which, in this population, is difficult to assess. Hence, patient satisfaction, although less objective, is of high importance. In this study, we have examined the relation of various functional parameters after non-fusion spinal surgery, with patient satisfaction.
PATIENTS AND METHODS: A 5-year follow-up after non-fusion lumbar spine surgery on 185 elderly patients was performed. Demographics, co-morbidity factors, type of lesion and operation performed were recorded. The Oswestry Disability Index (ODI) was calculated. Also, walking distance, use of analgesics, daily activities, social life and patient mobility were assessed by means of study-specific stratified pain- independent questionnaires. Finally, patient satisfaction was assessed by the single- item satisfaction question.
RESULTS: Post-operative ODI, and the improvement regarding ODI, analgesic use and walking distance indices were independent factors influencing patient satisfaction. The insertion of pain analog scale score into this model altered the results, and along with this score, only the walking distance improvement remained an independent statistically significant factor. When the independent from pain scales were used, the improvement of the walking distance score were independently related to the satisfaction of the elderly.
CONCLUSIONS: ODI is applicable in elderly patients, even with the exception of some of the categories assessed. Walking capacity should be assessed separately from other pain-dependent activities; its improvement should be an independent goal of lumbar spine surgery in the elderly. The level of the elderly patient subjectivity in auto- assessing the outcome of lumbar spine surgery is high, and objective outcome measurements remain important.

KEY WORDS: Elderly - Spinal surgery - Lumbar stenosis - Patient satisfaction - Quality of life

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Publication History

Article first published online: July 10, 2017
Manuscript accepted: July 4, 2017
Manuscript revised: June 29, 2017
Manuscript received: January 18, 2017

Per citare questo articolo

Bouras T, Zairi F, Loufardaki M, Triffaux M, Stranjalis G. Which functional outcome parameters correlate better with elderly patients’ satisfaction after non-fusion lumbar spine surgery?. J Neurosurg Sci 2017 Jul 10. DOI: 10.23736/S0390-5616.17.03977-7

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