Influence of age on the Surgical risk and prognosis in elderly patients with lumbar spinal stenosis

Abstract

Objective To evaluate the influence of age on the surgical risk and prognosis for elderly patients who suffered from lumbar spinal stenosis. Methods A total of 129 patients above 70 years old with lumbar stenosis from January 2015 to August 2018 were divided into 4 groups by age: younger than 69 years, 70-74 years, 75-79 years and 80 years and above. 50 patients below 69 years old were chosen at random as control group. Different parameters such as operation methods, predicted complication rate (POSSUM score), actual complication rate, number of operation levels, operation time, surgical blood loss, occult blood loss, total hospital stay, postoperative hospital stay, hospital cost and the ODI score in 3 months follow-up were recorded. The surgical risk and prognosis of elderly patients were analyzed by comparing the differences of above parameters between different age groups. Results There was no significant correlation between different age groups and surgical methods (F=15.637, P=0.208). The operation time and surgical blood loss both showed no significant difference between 4 groups. The predicted incidence of complications (POSSUM score) in group older than 80 years old (38.5%+12.34%) and 75-79 years old (41.1%+11.82%) were higher than the group younger than 69 years old (28.4%+15.44%). There was no significant difference between the two groups over 75 years old, and there was no significant difference between the 70-74 years old group and the other three groups. The actual incidence of complications was 43.75% in group over 80 years old, 42.86% in group 75-79 years old and 42.03% in group 70-74 years old. The actual complication rate of the group younger than 69 years was lower than other three groups, and the three other groups showed no significant difference between each other. The totally hospital stay and numbers of operation levels in groups 75-79 and 80 years and above were higher than groups 70-74 and 69 years and below. There was no significant difference in those parameters between groups 75-79 and 80 years and above, and between groups 70-74 years and 69 years and below. The ODI scores between 4 groups also showed no significant difference. Conclusion The risk of surgery for lumbar disc stenosis patients older than 75 years has increased, but the patient's surgical outcome has not decreased. Old age should not be a key factor in determining whether a patient is suitable for surgery. Key words: Lumbar vertebrae; Spinal stenosis; Aged; Intraoperative complications; Postoperative complications