The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis

Figures & data

Table 1 Summary of Included Studies

Study	US Clinical Trials Registry/IRB Approval	Study Design	Total mild Patients
Brown^Citation7	NCT00995371	Prospective, single center, randomized controlled study (mild vs ESI)	21
Deer^Citation8	NCT01076244	Prospective, single center case series	46
Mekhail^Citation10	IRB approved	Prospective, single center case series	40
MiDAS III	NCT01315145	Prospective, multicenter, two-arm observational study (mild vs ESI)	122

Figure 1 Flow diagram of study identification, exclusion and inclusion in the analysis.

Table 2 Descriptive Statistics for Included Studies

	Combined n = 209	Brown^Citation7 n = 17	Deer^Citation8 n = 44	Mekhail^Citation10 n = 39	MiDAS III n = 109
Age
Adults	49 (23.4%)	4 (23.5%)	17 (38.6%)	8 (20.5%)	20 (18.3%)
Older adults	160 (76.6%)	13 (76.5%)	27 (61.4%)	31 (79.5%)	89 (81.7%)
Gender
Female	122 (58.4%)	7 (41.2%)	28 (63.6%)	20 (51.3%)	67 (61.5%)
Male	87 (41.6%)	10 (58.8%)	16 (36.4%)	19 (48.7%)	42 (38.5%)

Figure 2 Change in outcomes with time within the adult group for (A) VAS, (B) ODI, (C) PDI, (D) Standing time, (E) RMQ, and (F) Walking distance.

Figure 3 Change in outcomes with time within the older adult group for (A) VAS, (B) ODI, (C) PDI, (D) Standing time, (E) RMQ, and (F) Walking distance.

Table 3 Descriptive Analysis and LMM Interaction Results

Measure	Age Group	Baseline	6M	12M	Fint	P
VAS	Adult	6.8 (2.0)	4.5 (2.7)	4.0 (2.7)	1.00	0.37
	Older adult	7.3 (1.8)	4.3 (3.0)	4.3 (3.1)
ODI	Adult	48.4 (11.3)	33.9 (17.8)	31.2 (21.0)	0.35	0.70
	Older adult	48.3 (12.1)	31.1 (18.5)	29.9 (19.0)
PDI	Adult	47.6 (14.8)	20.9 (12.7)	15.0 (10.7)	2.71	0.07
	Older adult	38.6 (12.1)	20.2 (15.2)	20.1 (14.3)
RMQ	Adult	13.4 (3.9)	6.3 (5.6)	7.0 (6.9)	0.08	0.92
	Older adult	14.4 (6.7)	7.0 (5.1)	6.7 (5.8)
Standing time (minutes)	Adult	7.9 (6.6)	48.1 (55.3)	80.0 (102.7)	1.88	0.16
	Older adult	8.2 (5.2)	28.9 (17.3)	43.2 (48.2)
Walking distance (feet)	Adult	473 (269)	7552 (9076)	5293 (6095)	0.03	0.98
	Older adult	206 (214)	2502 (3045)	3610 (3868)

Abbreviation: F_int, F value for interaction between age and time.

Figure 4 Change in outcomes across adult and older adult groups for (A) VAS, (B) ODI, (C) PDI, (D) Standing time, (E) RMQ, and (F) Walking distance.

Figure 5 Correlation between age and % change in VAS at (A) 6 months and (B) 12 months.

Table 4 VAS Linear Regression Analysis: Percent Reduction in Pain Does Not Change with Age

Values		6 Months			12 Months
		Estimates	CI	P	Estimates	CI	P
Predictors	α (intercept)	22.11	−29.42–73.65	0.40	41.12	3.34–85.58	0.07
	β (slope)	0.90	−2.66–4.46	0.62	−0.06	−3.13–3.00	0.97
Observations		203			184
R^2/adjusted R^2		0.001/-0.004			0.000/-0.005

Brown LL. A double-blind, randomized, prospective study of epidural steroid injection vs. the mild® procedure in patients with symptomatic lumbar spinal stenosis. Pain Pract. 2012;12:333–341. doi:10.1111/j.1533-2500.2011.00518.x

 PubMed Web of Science ®Google Scholar

Deer TR, Kim CK, Bowman RG 2nd, Ranson MT, Yee BS. Study of percutaneous lumbar decompression and treatment algorithm for patients suffering from neurogenic claudication. Pain Physician. 2012;15:451–460.

 PubMed Web of Science ®Google Scholar

Mekhail N, Costandi S, Abraham B, Samuel SW. Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression. Pain Pract. 2012;12:417–425. doi:10.1111/j.1533-2500.2012.00565.x

 Web of Science ®Google Scholar