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
{"title":"老年和非老年成人腰椎退行性病理全内窥镜手术后疼痛和功能结果的比较。","authors":"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","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>One hundred and sixty-four patients were included and divided into nongeriatric (<i>N</i> = 125) and geriatric (<i>N</i> = 39) cohorts. No group differences were observed between sex (<i>P</i> = 0.404), body mass index (<i>P</i> = 0.372), procedure duration (<i>P</i> = 0.350), or blood loss (<i>P</i> = 0.384). Nongeriatric patients received discectomy more frequently (<i>P</i> < 0.001), while older patients underwent more decompressive procedures (<i>P</i> < 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 (<i>P</i> < 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 (<i>P</i> > 0.05 for VAS back, VAS leg, and ODI).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical relevance: </strong>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.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology.\",\"authors\":\"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\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>One hundred and sixty-four patients were included and divided into nongeriatric (<i>N</i> = 125) and geriatric (<i>N</i> = 39) cohorts. No group differences were observed between sex (<i>P</i> = 0.404), body mass index (<i>P</i> = 0.372), procedure duration (<i>P</i> = 0.350), or blood loss (<i>P</i> = 0.384). Nongeriatric patients received discectomy more frequently (<i>P</i> < 0.001), while older patients underwent more decompressive procedures (<i>P</i> < 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 (<i>P</i> < 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 (<i>P</i> > 0.05 for VAS back, VAS leg, and ODI).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical relevance: </strong>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.</p><p><strong>Level of evidence: 3: </strong></p>\",\"PeriodicalId\":38486,\"journal\":{\"name\":\"International Journal of Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-12-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Spine Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14444/8693\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Spine Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14444/8693","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology.
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.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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