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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Uniportal microsurgical decompression for bilateral lumbar spinal canal stenosis in patients older than 74 years: Immediate post-surgical outcome and one-year follow-up

Einseitige mikrochirurgische Dekompression bei beidseitiger lumbaler Spinalkanalstenose bei Patienten, die älter als 74 Jahre sind: frühe postoperative Ergebnisse und Follow-up nach einem Jahr

Meeting Abstract

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  • corresponding author Erik Fritzsche - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • M. Thiel - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • L. Papavero - Neurochirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.03.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0173.shtml

Published: April 23, 2004

© 2004 Fritzsche et al.
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Outline

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Objective

Age and medical risk factors of patients requiring decompression of lumbar spinal canal stenosis (LSCS) are continuously increasing. In this prospective, single-center, non-randomized trial the surgical impact on pain intensity, walking performance, daily activity and analgetics consumption is investigated.

Methods

Fifty-five patients (34 females, mean age 79 years) presenting bilateral neurogenic claudication and medical risk factors (mean ASA 2.4) were microsurgically decompressed via the clinically dominant side at single or two levels (17). Pain intensity (VAS), walking performance (treadmill-test), functional status (Neurogenic Claudication Outcome Score: normal =100 points preop and 76 points postop) and analgetic medication (none, light, medium, heavy) was assessed in all patients by an independent observer preoperatively, one week and one year after surgery.

Results

One week postop: Pain decreased from VAS 7.3 to 3.3. The NCOS was rated 30.3/100 before and 53.7/76 after surgery. Walking distance improved in 34 patients (mean sixfold increase), did not change in 10 patients and shortened in four patients. The postoperative intake of analgetics decreased by one class (21), was unchanged (22) or increased by one classes (9). One year after surgery: unfortunately 24 patients could not be examined due to the geographic distance or to the in the meantime increased comorbidity. In 31 patients followed up pain was rated VAS 3.7 and the NCOS 60. The walking distance increased further (13), was consistent with the immediate postsurgical level (9) or decreased but was still better than preoperatively (9). The consumption of analgetics did not change. Complications: wrong level surgery and epidural hematoma accounted for two revisions. Three minor dural tears were sealed intraoperatively. Vertebral slip was fixed one year after surgery in one patient.

Conclusions

Uniportal microsurgical decompression for bilateral LSCS is well tolerated in elderly patients allowing for immediate mobilisation. One year after surgery the clinical benefit is still consistent.