title: Observations on the safety and efficacy of surgical decompression for lumbar spinal stenosis in geriatric patients.
abstract: This retrospective study examines the results of surgical decompression of the lumbar spinal canal in 122 geriatric patients (age range 75-89 years) treated under general anesthesia by the same surgeon between the years 1990 and 1999. Patient demographics, perioperative complications, pain profiles before surgery and at the time of data collection (December 2000), as well as overall mortality were recorded. One hundred and twenty-two patients were studied. The average age at the time of surgery was 78.8 years (range 75-89 years). No perioperative deaths were recorded. The mean time elapsed from surgery until patient follow-up was 45.7 months (range 12-119 months). Fourteen patients had died at the time of patient follow-up (December 2000). When compared to pain experienced before surgery, at the time of the interview a significant (P<0.0001) improvement in low-back and radicular pain as well as in the ability to perform daily activities (dressing, washing, getting out of bed and walking) was described. We conclude that, for geriatric patients rated as physical status I-II (>75 years) under the American Society of Anesthesiologists (ASA) classification, surgical release of lumbar spinal stenosis is a safe and effective treatment option. However, the suitability of ASA III patients requires further investigation.
authors.affiliation: Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba 44281, Israel. bdfgls@netvision.net.il
authors.forename: Brian
authors.initials: B
authors.lastname: Fredman
authors.forename: Zeev
authors.initials: Z
authors.lastname: Arinzon
authors.forename: Edna
authors.initials: E
authors.lastname: Zohar
authors.forename: Shai
authors.initials: S
authors.lastname: Shabat
authors.forename: Robert
authors.initials: R
authors.lastname: Jedeikin
authors.forename: Zeev G
authors.initials: ZG
authors.lastname: Fidelman
authors.forename: Reuven
authors.initials: R
authors.lastname: Gepstein
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D019299:Decompression, Surgical / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000401:mortality; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome