Clinical Efficacy Of Modified Transforaminal Lumbar Interbody Fusion For The Treatment Of Degenerative Lumbar Spinal Stenosis In The Elderly

Objective: To compare clinical efficacy of modified transforaminal lumbar interbody fusion(TLIF)for the treatment of degenerative lumbar spinal stenosis in two group(Group A ≥80yr,Group B 70~80yr)of elderly patients.Methods: From january 2013 to October 2015,153 patients older than 70 years diagnosed as degenerative lumbar spinal stenosis were treated with modified TLIF.We retrospectively study clinical efficacy of the above patients based on the follow-up results.The operation time,blood loss in operation and complications after operation were recorded and analyzed in both groups.The numerical rating scale(NRS)score,the Oswestry disability index(ODI)score and Japanese Orthopaedic Association(JOA)score were used to assess clinical outcomes before operation and at last follow-up.Results: The operations of 153 patients were successful and we obtained the last follow-up results of 105 patients.There were no severe complications in both groups A and group B in perioperative period.36 patients in group A were followed up from 6 months to 35 months.For the postoperative therapeutic effect,13 cases were regarded as excellent,14 good,7 fair and 2 bad,with a good rate of 75% in group A.69 patients in group B were followed up from 6 months to 38 months.For the therapeutic effect,37 cases were regarded as excellent,22 good,5 fair and 5 bad,with a good rate of 85.5%.There was no significant difference in good rate between the two groups.There were significant differences in the low back pain /leg pain NRS scores,ODI scores and JOA scores between pre-and post-operation in both groups(P<0.05,Wilcoxon signed-rank test).There were significant differences in the pre-/ post-operation ODI scores and pre-/ post-operation JOA scores between group A and group B(P<0.05,Wilcoxon signed-rank test).The difference in improvement rates of postoperative JOA between the two groups has statistical significance(P < 0.05,Wilcoxon signed-rank test).Conclusion: Modified transforaminal lumbar interbody fusion is a safe and effective treatment for degenerative lumbar spinal stenosis.In the short-term,TLIF can relieve lumbar and leg pain of patients aged 80 years or older significantly and improve quality of life of the octogenarian population.