Spinal Fusion Works in Elderly Despite Osteoporotic Bone
Specialized instruments and techniques helpful
FRIDAY, April 11 (HealthDay News) -- Using surgical rods and screws that are specially designed for osteoporotic bone allows good outcomes in elderly patients who undergo lumbar arthrodesis for severe lumbar stenosis, according to an article published in the April issue of the Journal of Spinal Disorders & Techniques.
Remi Cavagna, M.D., of University of Nantes in Nantes, France, and colleagues prospectively followed 39 elderly patients (mean age 73 years) with severe lumbar stenosis treated by lumbar arthrodesis using instrumentation adapted for osteoporotic bone. Outcomes after two to four years were assessed based on radiographic findings and Oswestry, Visual Analog Scale and Japanese Orthopaedic Association scores.
The patients showed very satisfactory improvements in lumbar and radicular pain, and results were maintained throughout the study period, the researchers report. No patients developed serious complications or required reoperation. Radiographic studies showed that 35 of 39 grafts appeared to have fused. The four patients without definite fusion were asymptomatic, the report indicates.
"The conditions for this surgery [in elderly patients] are different than those for younger patients and it is desirable to try to provide reliable surgical techniques and solutions regarding these options for instrumentation and overall perioperative care for these fragile patients. Dedicated instrumentation for osteoporotic bone seems to allow good clinical outcomes," the authors conclude.