Life expectancy after lumbar spine surgery: one- to eleven-year follow-up of 1015 patients.

Abstract

STUDY DESIGN: Retrospective study.

OBJECTIVES: To investigate the 10-year survival of a large number of elderly patients who underwent spine surgery for lumbar spinal stenosis, and to identify significant risk factors and compare them with age- and gender-matched controls from the general population.

SUMMARY OF BACKGROUND DATA: There have been many studies on treatment options and surgical outcomes for lumbar spinal stenosis. However, survival outcomes after lumbar spinal stenosis surgery have not previously been studied. Because these operations are usually performed for elderly patients, we consider patient survival or life expectancy to be a significant outcome measure.

METHODS: Between January 1997 and June 2006, patients underwent spine surgery for lumbar spinal stenosis. The date of death was verified using records from the National Health Insurance Corporation. Cumulative 10-year survival was calculated using the Kaplan-Meier method, and the survival of patients who had undergone spine surgery was compared to that of age- and sex-matched members of the general population. A Cox multivariate regression analysis was used in order to compare the survival rates for different covariates.

RESULTS: Using Kaplan-Meier curves, the overall 10-year survival was 87.8% in patients 60 to 70 years old at surgery, and 83.8% in patients 70 to 85 years old at surgery. The 10-year survival rate of female patients and patients who underwent fusion surgery were higher than those of male patients and patients with nonfusion surgery. Compared to the adjusted corresponding portion in general population, the standardized mortality ratios were 0.21, 0.53, and 0.45 in patients aged 50 to 59, 60 to 69, and 70 to 85, respectively.

CONCLUSION: Elderly patients who underwent spine surgery for spinal stenosis had reduced mortality compared to the corresponding portion of the general population. Therefore, surgery for spinal stenosis is a justifiable procedure even in elderly patients.