gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Surgical impact and benefit of spondylodesis in elderly patients

Meeting Abstract

  • Juliane Schroeteler - Klinik fuer Neurochirurgie Uniklinik Muenster, Muenster, Deutschland
  • Ronja Schroer - Klinik fuer Neurochirurgie Uniklinik Muenster, Muenster, Deutschland
  • Michael Schwake - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Stephanie Schipmann - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Nils Warneke - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik und Poliklinik für Neurochirurgie, Münster, Deutschland
  • Mark Klingenhöfer - Zentrum für Wirbelsäulentherapie, Städtisches Klinikum Dresden-Friedrichstadt, Dresden, Deutschland
  • Christian Ewelt - Klinik für Neurochirurgie, Universitätsklinik Münster, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.08.05

doi: 10.3205/17dgnc227, urn:nbn:de:0183-17dgnc2275

Published: June 9, 2017

© 2017 Schroeteler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The elderly population is poorly studied and constitutes a rapidly expanding surgical demographic. Although neurological deficits could be present, senior citizens are often surgically undertreated because of age and comorbidities. Due to this demographic change, we have to deal increasingly with old and severely diseased patients. Hence the question arises, if elderly patients do really profit from aggressive surgical treatment.

Methods: We performed a retrospective, single center, data base analysis. Data were extracted out of clinical data base due to search terms “patients with code spondylodesis”. The data were stratified by age and patients older than 68 years were chosen. Clinical outcome was extracted out of patients` file and the Owestry Disability Index was calculated retrospectively, as well. Surgical technical outcome represented screw placement, spine alignment and cage placement

Results: Data of 109 patients treated between 2011 and 2015 were analyzed. In the group, 61 patients were between 68-75 years old and 41 Patients were between 75 and 87 years old at time of surgery. Gender was distributed equally with 55 women and 49 men. 83% (n=91) of the patients had a cardiac history recorded. Indication of surgery was spondylodiscitis in 12, spondylosisthesis in 40 and fracture in 24 patients. In 53 patients 1 to 3 segments, in 24 patients 4 segments and in 24 cases 5 segments and more were operated. Preoperatively, the patients suffered from pain in 90.8% (n=99), sensory deficit in 35.8% (n= 39) and motor deficit in 33.9% (n= 37), as well as symptoms of spinal claudication in 52.3% (n= 57) of cases. Surgical adverse events were in 9.2% (n=10) wound infections, in 19.3% (n=21) screw dislocations, deep vain thrombosis in 0.9% (n=1) and pulmonary artery embolism in 8.3% (n=9) of the patients. Clinical neurological outcome was good in 27.5% (n=30) of all patients, worse in 6.4% (n=7), improved in 22.9% (n=25) and the same as without surgery in 15.6% (n=17). There was a significant correlation between number of segments treated and blood loss. The patients with preoperative Owestry Disability Index between 80 to 100% (n=30) could be reduced by surgery completely (n=0). Surgical technical outcome was without displacement or needed revision surgery in 90 patients (82.6%).

Conclusion: The Owestry Disability Index was reduced due to surgery in 30 patients. There were no severe adverse events despite this compromised patient collective. 55 Patients (50.4%) showed an improvement in clinical outcome. Surgical technical outcome was good in the majority of patients. Spondylodesis in elderly patients is feasible and most of the patients seem to benefit from spinal surgery.