Influence of age on pain intensity, functional impairment and health-related quality of life before and after surgery for lumbar degenerative disc disease

Highlights • Demographic changes will lead to a higher prevalence of patients with degenerative disc disease. • Elderly patients scheduled for surgical fusion showed less pain, functional impairment and higher HRQoL. • In patients scheduled for microdiscectomy and decompression, age has little or no...

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Published inClinical neurology and neurosurgery Vol. 150; pp. 33 - 39
Main Authors Gautschi, Oliver P., MD, Smoll, Nicolas R, Joswig, Holger, Corniola, Marco V, Schaller, Karl, Hildebrandt, Gerhard, Stienen, Martin N
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 01.11.2016
Elsevier Limited
Subjects
Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Back pain
Back Pain - physiopathology
Back Pain - surgery
Body mass index
Comorbidity
Decompression, Surgical
Degenerative disc disease
Diskectomy
Female
Functional impairment
Health-related quality of life
Hospitals
Humans
Hypotheses
Intervertebral Disc Degeneration - physiopathology
Intervertebral Disc Degeneration - surgery
Lumbar Vertebrae - surgery
Male
Medical personnel
Middle Aged
Neurology
Neurosurgery
Objective functional impairment
Older people
Outcome Assessment (Health Care)
Pain perception
Patients
Population
Prospective Studies
Quality of Life
Surgery
Timed Up and Go test
Young Adult
degenerative disc disease
timed up and go test
pain perception
functional impairment
objective functional impairment
health-related quality of life
age
Health-related quality of life
Pain perception
Timed Up and Go test
Functional impairment
Degenerative disc disease
Objective functional impairment
Age
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Abstract Highlights • Demographic changes will lead to a higher prevalence of patients with degenerative disc disease. • Elderly patients scheduled for surgical fusion showed less pain, functional impairment and higher HRQoL. • In patients scheduled for microdiscectomy and decompression, age has little or no effect on these grading scales.
AbstractList Background Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from degenerative disc disease (DDD). The goal of this study was to investigate age-related differences in pain intensity, subjective and objective functional impairment and health-related quality of life (HRQoL) in patients with lumbar DDD. Methods In a prospective two-center study, back and leg pain intensity (visual analogue scale (VAS)), functional impairment (Oswestry Disability Index (ODI), Roland-Morris Disability Index (RMDI)) and HRQoL (EuroQol-5D (EQ-5D), Short-Form (SF12)) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was measured using the Timed Up and Go (TUG) test. Adjusted partial correlation was used to correlate age to each scale preoperatively, as well as to the postoperative improvement at six weeks. Results A total of n=377 patients (161 females, 42.7%) with a mean age of 58.5 years (SD 15.7, range 18.0-93.7) were included. Unadjusted TUG test raw times naturally increased with age, whereas the age-effect on standardized OFI T-scores was close to zero in patients with a lumbar disc herniation (LDH; r=-0.0666, p=0.367) or lumbar spinal stenosis (LSS; r=-0.0134, p=0.879). There was a weak correlation between age and higher ODI (LDH: r=0.1289, p=0.089; LSS: r=0.1975; p=0.027), lower EQ-5D (LSS: r=-0.1824, p=0.042) and higher RMDI by trend (LSS: r=0.1679, p=0.061). The correlation between age and postoperative improvement was negative on the VAS for back pain (LDH: r=-0.3189, p=0.026), VAS for leg pain (LDH: r=-0.3656, p=0.009) and RMDI by trend (LSS: r=-0.2004, p=0.069), as well as positive on the EQ-5D index (r=0.2412, p=0.011), indicating that younger patients showed better improvement. Due to in-group heterogeneity, no age-effect could be calculated for patients scheduled for surgical fusion. Conclusions The influence of age on subjective and objective measures of pain, functional impairment and HRQoL is limited for patients with LDH and LSS, but suggests an age-dependent increase of functional disability. Younger patients generally showed greater postoperative improvement at six weeks than older patients.
Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from degenerative disc disease (DDD). The goal of this study was to investigate age-related differences in pain intensity, subjective and objective functional impairment and health-related quality of life (HRQoL) in patients with lumbar DDD. In a prospective two-center study, back and leg pain intensity (visual analogue scale (VAS)), functional impairment (Oswestry Disability Index (ODI), Roland-Morris Disability Index (RMDI)) and HRQoL (EuroQol-5D (EQ-5D), Short-Form (SF12)) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was measured using the Timed Up and Go (TUG) test. Adjusted partial correlation was used to correlate age to each scale preoperatively, as well as to the postoperative improvement at six weeks. A total of n=377 patients (161 females, 42.7%) with a mean age of 58.5 years (SD 15.7, range 18.0-93.7) were included. Unadjusted TUG test raw times naturally increased with age, whereas the age-effect on standardized OFI T-scores was close to zero in patients with a lumbar disc herniation (LDH; r=-0.0666, p=0.367) or lumbar spinal stenosis (LSS; r=-0.0134, p=0.879). There was a weak correlation between age and higher ODI (LDH: r=0.1289, p=0.089; LSS: r=0.1975; p=0.027), lower EQ-5D (LSS: r=-0.1824, p=0.042) and higher RMDI by trend (LSS: r=0.1679, p=0.061). The correlation between age and postoperative improvement was negative on the VAS for back pain (LDH: r=-0.3189, p=0.026), VAS for leg pain (LDH: r=-0.3656, p=0.009) and RMDI by trend (LSS: r=-0.2004, p=0.069), as well as positive on the EQ-5D index (r=0.2412, p=0.011), indicating that younger patients showed better improvement. Due to in-group heterogeneity, no age-effect could be calculated for patients scheduled for surgical fusion. The influence of age on subjective and objective measures of pain, functional impairment and HRQoL is limited for patients with LDH and LSS, but suggests an age-dependent increase of functional disability. Younger patients generally showed greater postoperative improvement at six weeks than older patients.
Highlights • Demographic changes will lead to a higher prevalence of patients with degenerative disc disease. • Elderly patients scheduled for surgical fusion showed less pain, functional impairment and higher HRQoL. • In patients scheduled for microdiscectomy and decompression, age has little or no effect on these grading scales.
BACKGROUNDDemographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from degenerative disc disease (DDD). The goal of this study was to investigate age-related differences in pain intensity, subjective and objective functional impairment and health-related quality of life (HRQoL) in patients with lumbar DDD.METHODSIn a prospective two-center study, back and leg pain intensity (visual analogue scale (VAS)), functional impairment (Oswestry Disability Index (ODI), Roland-Morris Disability Index (RMDI)) and HRQoL (EuroQol-5D (EQ-5D), Short-Form (SF12)) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was measured using the Timed Up and Go (TUG) test. Adjusted partial correlation was used to correlate age to each scale preoperatively, as well as to the postoperative improvement at six weeks.RESULTSA total of n=377 patients (161 females, 42.7%) with a mean age of 58.5 years (SD 15.7, range 18.0-93.7) were included. Unadjusted TUG test raw times naturally increased with age, whereas the age-effect on standardized OFI T-scores was close to zero in patients with a lumbar disc herniation (LDH; r=-0.0666, p=0.367) or lumbar spinal stenosis (LSS; r=-0.0134, p=0.879). There was a weak correlation between age and higher ODI (LDH: r=0.1289, p=0.089; LSS: r=0.1975; p=0.027), lower EQ-5D (LSS: r=-0.1824, p=0.042) and higher RMDI by trend (LSS: r=0.1679, p=0.061). The correlation between age and postoperative improvement was negative on the VAS for back pain (LDH: r=-0.3189, p=0.026), VAS for leg pain (LDH: r=-0.3656, p=0.009) and RMDI by trend (LSS: r=-0.2004, p=0.069), as well as positive on the EQ-5D index (r=0.2412, p=0.011), indicating that younger patients showed better improvement. Due to in-group heterogeneity, no age-effect could be calculated for patients scheduled for surgical fusion.CONCLUSIONSThe influence of age on subjective and objective measures of pain, functional impairment and HRQoL is limited for patients with LDH and LSS, but suggests an age-dependent increase of functional disability. Younger patients generally showed greater postoperative improvement at six weeks than older patients.
•Demographic changes will lead to a higher prevalence of patients with degenerative disc disease.•Elderly patients scheduled for surgical fusion showed less pain, functional impairment and higher HRQoL.•In patients scheduled for microdiscectomy and decompression, age has little or no effect on these grading scales. Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from degenerative disc disease (DDD). The goal of this study was to investigate age-related differences in pain intensity, subjective and objective functional impairment and health-related quality of life (HRQoL) in patients with lumbar DDD. In a prospective two-center study, back and leg pain intensity (visual analogue scale (VAS)), functional impairment (Oswestry Disability Index (ODI), Roland-Morris Disability Index (RMDI)) and HRQoL (EuroQol-5D (EQ-5D), Short-Form (SF12)) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was measured using the Timed Up and Go (TUG) test. Adjusted partial correlation was used to correlate age to each scale preoperatively, as well as to the postoperative improvement at six weeks. A total of n=377 patients (161 females, 42.7%) with a mean age of 58.5 years (SD 15.7, range 18.0-93.7) were included. Unadjusted TUG test raw times naturally increased with age, whereas the age-effect on standardized OFI T-scores was close to zero in patients with a lumbar disc herniation (LDH; r=−0.0666, p=0.367) or lumbar spinal stenosis (LSS; r=−0.0134, p=0.879). There was a weak correlation between age and higher ODI (LDH: r=0.1289, p=0.089; LSS: r=0.1975; p=0.027), lower EQ-5D (LSS: r=−0.1824, p=0.042) and higher RMDI by trend (LSS: r=0.1679, p=0.061). The correlation between age and postoperative improvement was negative on the VAS for back pain (LDH: r=−0.3189, p=0.026), VAS for leg pain (LDH: r=−0.3656, p=0.009) and RMDI by trend (LSS: r=−0.2004, p=0.069), as well as positive on the EQ-5D index (r=0.2412, p=0.011), indicating that younger patients showed better improvement. Due to in-group heterogeneity, no age-effect could be calculated for patients scheduled for surgical fusion. The influence of age on subjective and objective measures of pain, functional impairment and HRQoL is limited for patients with LDH and LSS, but suggests an age-dependent increase of functional disability. Younger patients generally showed greater postoperative improvement at six weeks than older patients.
Author Schaller, Karl
Corniola, Marco V
Hildebrandt, Gerhard
Stienen, Martin N
Joswig, Holger
Gautschi, Oliver P., MD
Smoll, Nicolas R
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  fullname: Schaller, Karl
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/27579779$$D View this record in MEDLINE/PubMed
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Keywords degenerative disc disease
timed up and go test
pain perception
functional impairment
objective functional impairment
health-related quality of life
age
Health-related quality of life
Pain perception
Timed Up and Go test
Functional impairment
Degenerative disc disease
Objective functional impairment
Age
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Snippet Highlights • Demographic changes will lead to a higher prevalence of patients with degenerative disc disease. • Elderly patients scheduled for surgical fusion...
•Demographic changes will lead to a higher prevalence of patients with degenerative disc disease.•Elderly patients scheduled for surgical fusion showed less...
Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from...
Background Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from...
BACKGROUNDDemographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from...
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StartPage 33
SubjectTerms Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Back pain
Back Pain - physiopathology
Back Pain - surgery
Body mass index
Comorbidity
Decompression, Surgical
Degenerative disc disease
Diskectomy
Female
Functional impairment
Health-related quality of life
Hospitals
Humans
Hypotheses
Intervertebral Disc Degeneration - physiopathology
Intervertebral Disc Degeneration - surgery
Lumbar Vertebrae - surgery
Male
Medical personnel
Middle Aged
Neurology
Neurosurgery
Objective functional impairment
Older people
Outcome Assessment (Health Care)
Pain perception
Patients
Population
Prospective Studies
Quality of Life
Surgery
Timed Up and Go test
Young Adult
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Title Influence of age on pain intensity, functional impairment and health-related quality of life before and after surgery for lumbar degenerative disc disease
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