Is Advanced Age a Factor That Influences the Clinical Outcome of Single- or Double-Level MIS-TLIF? A Single-Center Study with a Minimum Two-Year Follow-Up on 103 Consecutive Cases

As life expectancy rises, more elderly people undergo spinal fusion surgery to treat lumbar degenerative diseases. The MIS-TLIF technique, which minimizes soft tissue manipulation, is a promising fusion technique for frailer patients. The aim of this study was to investigate if older age is a significant factor in the clinical outcome of single- or double-level MIS-TLIF. A cross-sectional study was conducted on 103 consecutive patients. Data were compared between younger (<65 y.o.) and older (& GE;65 y.o.) patients. We observed no significant differences between baseline characteristics of the two groups apart from the frequency of disk space treated, with a relative predominance of L3-L4 space treated in the elderly (10% vs. 28%, p = 0.01) and L5-S1 space in younger patients (36% vs. 5%, p = 0.006). There was no significant difference in complication rate, surgical satisfaction, EQ 5D-5L, or Oswestry Disability Index (ODI) global or specific scores, with the exception of the EQ 5D-5L mobility score, where older patients fared worse (1.8 & PLUSMN; 1.1 vs. 2.3 & PLUSMN; 1.4; p = 0.05). The minimal invasiveness of the surgical technique, age-related specific outcome expectations, and biomechanical issues are all potential factors influencing the lack of age group differences in outcome scores.

Automated summary

As life expectancy rises, more elderly people are undergoing spinal fusion surgery using the MIS-TLIF technique. This study aimed to investigate if older age affects the clinical outcome of MIS-TLIF surgery. Data from 103 patients were compared between younger and older patients, and it was found that there were no significant differences in most outcome scores except for the mobility score, where older patients had worse outcomes. Factors such as surgical technique, age-related expectations, and biomechanical issues may contribute to the lack of age group differences in outcome scores.