Universität zu Köln

Leyendecker, Jannik ORCID: 0009-0002-4439-4702, Prasse, Tobias ORCID: 0000-0002-3767-5461, Rückels, Pia, Köster, Malin, Rumswinkel, Lena, Schunk, Valentina, Marossa, Isabella, Eysel, Peer ORCID: 0009-0004-6057-6092, Bredow, Jan ORCID: 0000-0003-2311-4409, Hofstetter, Christoph P. and Khan, Imad (2024). Full-endoscopic spine-surgery in the elderly and patients with comorbidities. Scientific Reports, 14 (1). pp. 1-9. Springer Nature. ISSN 2045-2322

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Abstract

[Artikel-Nr.: 29188] Due to demographic changes, a growing number of elderly patients with comorbidities will require spine surgery in the next decades. However, age and multimorbidity have been associated with considerably worse postoperative outcomes, and is often associated with surgical invasiveness. Full-endoscopic spine-surgery (FESS), as a cornerstone of contemporary minimally invasive surgery, has the potential to mitigate some of these disparities. Thus, we conducted an analysis of all FESS cases at a national center. Utilizing the Charlson Comorbidity index (CCI) ≥ 3 as a frailty surrogate we separated patients in two groups for patients with and without comorbidities. Patients with (CCI) ≥ 3 exhibited a higher age ( p < 0.001), and number of comorbidities ( p < 0.001) than the control group. Thereafter, a propensity score matching was done to adjust for potential confounders. Postoperative safety measures in emergency department utilization, and clinic readmission did not significantly differ between the groups. Furthermore, patients of both groups reported similar postoperative pain improvements. However, patients with a (CCI) ≥ 3 were treated as inpatients more often ( p < 0.001), had a higher length of stay ( p < 0.001) and a smaller functional improvement after at a chronic postoperative timepoint ( p = 0.045). The results underline safety and efficacy of FESS in patients with comorbidities. Additionally, they provide guidance for preoperative patient counselling and resource utilization when applying FESS in frail patients.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Leyendecker, Jannik UNSPECIFIED https://orcid.org/0009-0002-4439-4702 UNSPECIFIED Prasse, Tobias UNSPECIFIED https://orcid.org/0000-0002-3767-5461 UNSPECIFIED Rückels, Pia UNSPECIFIED UNSPECIFIED UNSPECIFIED Köster, Malin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rumswinkel, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Schunk, Valentina UNSPECIFIED UNSPECIFIED UNSPECIFIED Marossa, Isabella UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED https://orcid.org/0009-0004-6057-6092 UNSPECIFIED Bredow, Jan UNSPECIFIED https://orcid.org/0000-0003-2311-4409 UNSPECIFIED Hofstetter, Christoph P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Khan, Imad UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-816060
Identification Number:	10.1038/s41598-024-80235-2
Journal or Publication Title:	Scientific Reports
Volume:	14
Number:	1
Page Range:	pp. 1-9
Number of Pages:	9
Date:	25 November 2024
Publisher:	Springer Nature
ISSN:	2045-2322
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Chirurgie > Abteilung Unfallchirurgie (Klinik und Poliklinik für Orthopädie und Unfallchirurgie)
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81606