Abstract
Objective: To assess the safety and outcome of laminectomy in patients with spinal stenosis operated at the age of 65 years or older. The relation between the duration of the symptoms and results was investigated.
Study Design: A retrospective chart analysis with up to 10 years follow-up.
Setting: The Spinal Care Unit, Meir Medical Center, Kfar Saba, Israel.
Material and Methods: The medical records of all patients who had laminectomy for spinal stenosis at the age of 65 or more in a 10 years period were reviewed. Assessment of pain, ability to perform the basic activities of daily living, transferring dressing and basing before and after the operation was done by a telephone interview. Patient’s self-estimation of the final result of the surgery was also recorded.
Results: Two hundred eight-three patients were eligible to participate in the study.
They were allocated into 3 groups according to the duration of symptoms before surgery. Group A with symptoms lasting up to 24 months, B with 25–48 months and C with symptoms lasting for more than 48 months. The average age at the time of the operation was 68.9, 72.6 and 71.3 years, respectively. Forty-eight patients died and 18 refused or were not able to participate in the study. The average time of follow-up was 43.3 months, 42.2 in group A, 47.4 in B and 42.8 in C.
No significant differences were noticed in the demographic, anesthetic and surgical parameters among the 3 groups.
There were no mortality cases in the immediate postoperative period. The overall complication rate was 43.5%, nearly identical in all 3 groups. Two patients had cerebrovascular accident and 5 had myocardial ischemia but no one turned into infarction. Mild complications included 11 urinary retention, 24 urinary tract infections and 11 patients with superficial wound infection. Twenty-two patients were re-operated along the follow-up period.
There was remarkable improvement in the perception of pain, walking distances and in the ability to perform basic activities of daily living in all 3 groups. Self-assessment of the final results disclosed 70% satisfied patients in group A, 67% in B and 67% in C.
Conclusion: Surgery for spinal stenosis in elderly patients is safe and often lead to significant relief of pain and improvement in the quality of life. Delaying surgery had no deleterious effect on the operative results.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
