gms | German Medical Science

Adequate treatment of elderly patients has become more and more a subject of interest - even politicians focussed on that - but not because of charity but of reducing costs for health insurance. Effectiveness of lumbar spine surgery in elderly patients-70 years and older-is tested by considering outcome and complications.

52 patients undergoing lumbar spinal stenosis surgery or microdiscectomy between 11/´01 to 11/´03 were retrospectively reviewed with an average follow-up of 3 months. Average age of 24 women and 28 men was 75,4 years. 8 patients had no comorbidities, the rest had typical comorbidities. 14 patients underwent discectomy only, 15 decompression surgery only (4 of them with laminectomy) and 23 had decompression and microdiscectomy. 11 patients were operated at 2 lumbar levels, 41 at one level only. No fusion was necessary.

There was no mortality at this study. 60% (31) of patients were satisfied and pain relief was significant, but no patient was totally without pain or deficit. 27% (14) of the patients improved clearly after surgery and had evident relief of pain but with recognizable rest symptoms or deficits. 13% (7) of the patients did not profit and were not satisfied with the result of surgery, but none suffered additional permanent deficit. 33% complications occurred without permanent deficit. 5 recurrent lumbar disc herniations occurred, 1 spondylodiscitis, 2 dural leakages, 2 minor thrombosis, 7 minor complications of surgery such as nausea.

The findings of this study support the evidence that lumbar decompressive surgery and microdiscectomy is a safe and effective means of treating sciatic pain and/or claudicatio spinalis symptoms of disc herniation and lumbar spinal stenosis of elderly patients.