Abstract
There are increasing opportunity of operative treatment for advanced aged patients with degenerative spinal disease aiming for better quality of life. We have studied such patients concerning operative result, complication and problem in pre- and peri- operative management, and achievement of their aims.
Patients and Results: 1) 26 patients were analyzed; 16 males and 10 females, av. aged 82.3, pts of 19 lumbar canal stenosis with marked intermittent claudication and 7 disc herniation. 2) Low back pain and neurogenic disabilities are evaluated on JOA scoring criteria excepting ADL points (full score:15).
Results: 1) 25 of 26 pts had following complications before operation; hypertension in 16, neurogenic bladder 7, arrhythmia 6, prostata hypertrophy 6, cardiac ischemic disease 4, DM 3, cerebral infarction 3, advanced OA of the knee joints 3. asthma 2, pulmonary emphysema 2, Parkinsonism 1, respectively. 2) All patients underwent laminectomy of av. 2.2 segments(1~4), and 3 pts had PL fusion. 3) One had postlaminectomy haematoma complicated with neurologic deterioration 3 hrs after operaion. He underwent immediate revision which resulted complete recovery of neurology. 4) One pt with pulmonary emphysema was operated successfully with lumbar anaesthesia as general anaesthesia was refused. 5) Improvement evaluated with modified JOA pain score accounted for as follows; av. preoperative score showed 7.16 improved to 10.73 (45.8%), objective symptoms 4.23–4.66, subjective symptome 3.0–6.08 (51.3%), ambulant ability improved from 0.35–2.0 (62.3%), and pain ± numbness of L/E 0.96–2.04 (52.9%) resp. 6) 2 patient
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
