[Sciatica in the elderly. Apropos of 27 cases operated after the age of 70].
From a study of 27 operations for common vertebral sciatica in the elderly, certain specific features stand out. L5 sciatica is predominant though curiously, the pain relieving posture is less frequent than in the S1 variety. The condition is usually most painful at night. In 50% of cases there is a motor deficit which to a great extend determines the decision to operate. Finally, there is very good correlation between clinical features and the discovery of a prolapsed disc. Osteoarthrotic lesions are much more common than in the general sciatica population but the disc protrusion always keeps its localising value. Surgical intervention reveals that the disc plays an equally important role at this age as a prolapsed disc was found in 26 cases (11 extruded herniated discs and 2 ruptured). These lesions are less common in the general sciatica population. In about two thirds of patients a herniated disc alone is found and in the others, it is associated with osteoarthrotic lesions although these do not appear to compromise the success of the operation. Amongst the 9 post-operative complications, there was one death due to pulmonary emboli and 2 cases of reflex algodystrophy of the foot on the operated side. With a mean delay of more than 1 year, a frank improvement was noted in 85% of cases as against 80% immediately following surgery. Only one case of recurrence was reported.
D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D012585:Sciatica / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors
La sciatique du sujet agé. A propos de 27 cas opérés après 70 ans.