ArticleActa orthopaedica2009
Impact of instrumentation in lumbar spinal fusion in elderly patients: 71 patients followed for 2-7 years.
Article in Acta orthopaedica, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Pooled it
- Minimally invasive versus open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2015Pooled it
- Degenerative lumbar spinal stenosis with osteoporotic vertebral fracture involving endplate: a retrospective study.BMC surgery · 2025Article
- Noninstrumented Posterolateral Lumbar Fusions Continue to Fade Relative to Instrumented Posterolateral Approaches for Lumbar Degenerative Spondylolisthesis Over the Past Decade.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Enhanced recovery after surgery (ERAS) improves outcomes in elderly patients undergoing short-level lumbar fusion surgery: a retrospective study of 333 cases.European journal of medical research · 2024Article
- Posterior Instrumented Spinal Surgery Outcomes in the Elderly: A Comparison of the 5-Item and 11-Item Modified Frailty Indices.Global spine journal · 2024Article
- Instrumented lumbar fusion in patients over 75 years of age: is it worthwhile?-a comparative study of the improvement in quality of life between elderly and young patients.Journal of spine surgery (Hong Kong) · 2023Article
- Article
- Allograft Versus Demineralized Bone Matrix in Instrumented and Noninstrumented Lumbar Fusion: A Systematic Review.Global spine journal · 2018Review
- Instrumented Spinal Stabilization without Fusion for Spinal Metastatic Disease.World neurosurgery · 2018Article
- Osteoporosis and the Management of Spinal Degenerative Disease (I).The archives of bone and joint surgery · 2017Review
- Surgical outcomes after instrumented lumbar surgery in patients of eighty years of age and older.BMC musculoskeletal disorders · 2016Article
- A review: Reduced reoperation rate for multilevel lumbar laminectomies with noninstrumented versus instrumented fusions.Surgical neurology international · 2016Article
- Low reoperation rate following 336 multilevel lumbar laminectomies with noninstrumented fusions.Surgical neurology international · 2016Article
- Clinical and radiographic outcomes of concentrated bone marrow aspirate with allograft and demineralized bone matrix for posterolateral and interbody lumbar fusion in elderly patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2015Article
- Instrumented fusion surgery in elderly patients (over 75 years old): clinical and radiological results in a series of 53 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2013Article
- Long-term health care utilisation and costs after spinal fusion in elderly patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2013Article
- Improving the clinical evidence of bone graft substitute technology in lumbar spine surgery.Global spine journal · 2012Review
- Outcomes of Instrumented Posterolateral Fusion for Patients Over 70 Years with Degenerative Lumbar Spinal Disease: A Minimum of 2 Years Follow-up.Korean Journal of Spine · 2012Article
- Instrumented intervertebral or posterolateral fusion in elderly patients: clinical results of a single center.BMC musculoskeletal disorders · 2011Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAn increasing number of lumbar fusions are performed using allograft to avoid donor-site pain. In elderly patients, fusion potential is reduced and the patient may need supplementary stability to achieve a solid fusion if allograft is used. We investigated the effect of instrumentation in lumbar spinal fusion performed with fresh frozen allograft in elderly patients.
methods94 patients, mean age 70 (60-88) years, who underwent posterolateral spinal fusion either non-instrumented (51 patients) or instrumented (43 patients) were followed for 2-7 years. Functional outcome was assessed with the Dallas pain questionnaire (DPQ), the low back pain rating scale pain index (LBPRS), and SF-36. Fusion was assessed using plain radiographs.
resultsInstrumented patients had statistically significantly better outcome scores in 6 of 7 parameters. Fusion rate was higher in the instrumented group (81% vs. 68%, p = 0.1). Solid fusion was associated with a better functional outcome at follow-up (significant in 2 of 7 parameters). 15 patients (6 in the non-instrumented group and 9 in the instrumented group) had repeated lumbar surgery after their initial fusion procedure. Functional outcome was poorer in the group with additional spine surgeries (significant in 4 of 7 parameters).
interpretationSuperior outcomes after lumbar spinal fusion in elderly patients can be achieved by use of instrumentation in selected patients. Outcome was better in patients in which a solid fusion was obtained. Instrumentation was associated with a larger number of additional surgeries, which resulted in a lesser degree of improvement. Instrumentation should not be discarded just because of the age of the patient.
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Registered trials
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