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=21), patients between 60 and 79 years (Group 2, n=54), and > age of 80 years (Group 3, n=15).
Data with regard to intra- and post-operative complications and subjective outcome variables were collected. These included pain (VAS), walking distance, Oswestry Disability score (ODI) and patient satisfaction scores.
Results
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. All three groups reported improvement in their walking distance. The average walking distance improved by factor 5 in groups 1 and 2 and by factor 2.5 in group 3 (p< 0.05).
However the improvement in group 3 was not statistically significant. There was a statistically significant improvement in ODI for all three groups (mean ODI improvement in Group 1, 16 points, Group 2, 23 points and Group 3, 15 points). Overall 96% of patients were satisfied and would consider the same treatment again under similar circumstances. The overall complication was 19% in group 1, 18% in group 2, and 33% in group 3.
Conclusions
Surgery for neurogenic claudication in the octogenarian is associated with a higher complication rate. The outcomes however in this patient group are comparable to younger patients. Lumbar decompression surgery in octogenarians is a worthwhile procedure.
