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LUMBAR SPINE DECOMPRESSION IN THE ELDERLY: TOO MUCH, TOO LATE? A COMPARISON OF OUTCOMES & COMPLICATIONS.



Abstract

Aim: To evaluate morbidity and outcome associated with lumbar spine decompression for central spinal stenosis in the elderly compared with younger age groups.

Patients & Methods: Case notes review of patients with symptomatic and MRI proven central lumber canal stenosis, under the care of a single surgeon. The study population was 3 age groups: patients < 60 year of age (Group 1, n=19), patients between 61 and 79 years(Group 2, n=54), and > age of 80 years (Group 3, n=15).

The number of levels decompressed & grade of surgeon were noted.

Outcome data: Length of operation & hospital stay, blood loss, and intra and post operative complications. Subjective variables: Pain (VAS), walking distance, Oswestry Disability score (ODI) and patient satisfaction scores.

Results: The duration of operation (p< 0.05), and intra-operative complication rate (p< 0.025) was dependent on the seniority of the surgeon.

There was a statistically significant improvement in VAS score for leg pain (p< 0.05) and back pain (p< 0.05) after surgery for each group. The average walking distance improved by factor 5 in group 1 and 2 and by factor 2.5 in group 3 (p< 0.05)

Conclusions: Surgery for neurogenic claudication in the octogenarian is associated with a higher complication rate. The outcomes in this patient group is however comparable to younger patients.

Correspondence should be addressed to: Mr N. J. Henderson, BASS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.