Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Objectives To compare clinical outcomes after decompressive surgery for central lumbar spinal stenosis ( LSS ) in individuals aged 80 and older with those of individuals aged 18–79. Design Prospective data from the Norwegian Registry for Spine Surgery. Setting Multicenter observational study. Participants Individuals with central LSS undergoing surgery at 36 orthopedic or neurosurgical departments (N = 1,503; 1,325 aged <80 (median 66, range 21–79); 178 aged ≥80 (median 82, range 80–95)). Intervention Laminectomy or microdecompression. Measurements Changes in Oswestry Disability Index ( ODI ), EuroQol 5D ( EQ ‐5D), back pain numerical rating scale ( NRS ), and leg pain NRS at 1 year. Complications and duration of surgical procedures and hospital stays are reported. Results For all participants, there was a significant improvement in ODI (difference 16.60 points, 95% confidence interval ( CI ) = 15.59–17.61, P < .001). There were no differences between age cohorts in mean changes in ODI (0.2, 95% CI = −3.05–3.39, P = .92), EQ ‐5D (0.02, 95% CI = −0.04–0.09, P = .49), back pain NRS (−0.2, 95% CI = −0.7–0.4, P = .56), or leg pain NRS (−0.1, 95% CI = −0.7–0.5), P = .77). There were no differences in perioperative complications between age cohorts (4.9% vs 7.9%, P = .11). Participants aged 80 and older reported more complications occurring within 3 months (11.8% vs 7.5%, P = .02), mainly because of more urinary tract infections (9.6% vs 3.5%, P = .001). Mean duration of hospital stays was 1.3 days longer for participants aged 80 and (4.5 vs 3.2 days, P < .001). There were no differences in duration of single‐level microdecompression ( P = .94), two‐level microdecompression ( P = .53), single‐level laminectomy ( P = .78), or two‐level laminectomy ( P = .08). Conclusion Individuals aged 80 and older experience improvement in self‐reported outcomes similar to those of younger individuals after decompressive surgery for LSS .