Clinical features and surgical outcomes of lumbar spinal stenosis in patients aged 80 years or older: a multi-center retrospective study

Abstract

With increased aging of the population, spine surgeons have more opportunity to treat elderly patients for lumbar spinal stenosis (LSS). The purpose of this study was to clarify the clinical features and surgical outcomes for LSS in the elderly aged 80years or older. We retrospectively reviewed 702 consecutive patients with LSS who underwent decompression surgery without fusion between 2006 and 2010. Patients with other conditions that could affect functional status were excluded from this study. Of the remaining 304 patients, 241 with LSS whose condition could be evaluated 6months at least after surgery were analyzed. The mean follow-up period was 14.4months (range 6-60months). There were 144 males and 97 females aged 45-93years old (average: 72.2years old). Patients were divided into two age groups: 80years or older (Group A, 46 patients) and under 80years of age (Group B, 195 patients). We evaluated differences in the clinical features and surgical outcomes between the two groups. There were no significant differences in surgical levels, the number of operation levels, operation times, or the amount of intraoperative bleeding between Groups A and B. The percentages of patients with comorbidities were 73.9% in Group A and 60.0% in Group B, which were not significantly different. There were no significant differences in Japanese Orthopaedic Association scores preoperatively, 6months postoperatively, and at the final follow-up between the two groups. Furthermore, recovery ratios 6months postoperatively and at final follow-up were similar between the two groups. The percentages of patients with postoperative complications were 19.6% in Group A and 13.3% in Group B, which were not significantly different. This multi-center retrospective study demonstrated that the benefits and risks of decompression surgery for LSS were similar between patients aged over 80years and those under 80years. Therefore, decompression surgery is a reasonable treatment even for elderly patients aged over 80years.