Clinical Analysis of Postoperative Outcome in Elderly Patients with Lumbar Spinal Stenosis

Abstract

Objective : The purpose of this study was to evaluate the efficacy and safety of the surgical treatment for lumbar spinal stenosis in elderly patients. Methods : The authors reviewed the medical records of 49 patients older than 65 years of age with lumbar spinal stenosis who underwent surgical treatment from January 2002 to December 2004 in our institute. Results : Average age of patients was 70 years old (32 women, 17 men). Twenty-four patients had chronic medical disorders. All patients were operated under the general anesthesia of these, 29 patients underwent decompressive laminectomy and decompressive laminectomy with instrumentation and fusion in 20 patients. The mean operation time was 193.5 minutes, mean estimated blood loss was 378cc and mean postoperative hospital stay length was 15.3 days. The mean follow-up duration was 11.9 months. The evaluation of outcome was assessed by Macnab classification. At first month after operation, the outcome showed excellent in 7 (14.3%), good in 35 (71.4%), fair in 5 (10.2%), and poor in 2 (4.1%). And at 6 months after operation, 17 patients were lost in follow-up, the outcome showed excellent in 4 (12.5%), good in 25 (78.1%), fair in 3 (9.4%), and no poor cases. There was no significant difference between outcome of laminectomy alone and that of laminectomy with fusion. Six patients (12.2%) experienced postoperative complications which included wound infection (3), nerve root injury (1), disc herniation (1), and reoperation due to insufficient decompression (1). There were no deaths related to operation. Conclusion : We conclude that the surgical treatment for lumbar spinal stenosis in elderly patients can provide good results with acceptable morbidity when carefully selected. In addition, decision on lumbar spinal fusion should not be against solely on advanced age.