title: Minimally invasive lumbar spinal decompression in the elderly: outcomes of 50 patients aged 75 years and older.
abstract: OBJECTIVE
  Lumbar spinal stenosis and spondylosis are major causes of morbidity among the elderly. Surgical decompression is an effective treatment, but many elderly patients are not considered as candidates for surgery based on age or comorbidities. Minimally invasive surgical techniques have recently been developed and used successfully for the treatment of lumbar spinal disease. Our objective was to examine the safety and efficacy of minimally invasive lumbar spinal surgery for elderly patients.
  
  
  METHODS
  We reviewed demographic information, pre- and postoperative Visual Analog Scale pain scores, Oswestry Disability Index scores, and Short-Form 36 scores of prospectively accrued patients who underwent minimally invasive decompression of lumbar degenerative disease at two institutions between January 2002 and December 2005. Data from patients who were at least 75 years old were selected. Statistical analysis methods included paired t test, multiple linear regression, and linear mixed effects modeling.
  
  
  RESULTS
  Fifty-seven patients with a mean age of 81 years met the study criteria (median follow-up period, 7 mo; mean follow-up period, 10 mo). No major complications or deaths occurred. Fifty patients had sufficient outcomes data for analysis. Visual Analog Scale pain scores decreased from 5.7 to 2.2 for back pain and from 5.7 to 2.3 for symptomatic leg pain (P < 0.05). Oswestry Disability Index scores decreased from 48 to 27; Short-Form 36 Body Pain and Physical Function scores also showed statistically significant improvements after surgery (P < 0.05). The longitudinal analysis demonstrated durability of the symptom relief.
  
  
  CONCLUSIONS
  Minimally invasive lumbar spine decompression is a safe and efficacious treatment for elderly patients with spinal stenosis and spondylosis. Elderly patients should be considered good candidates for lumbar surgical decompression using minimally invasive techniques.
authors.affiliation: Section of Neurosurgery, Department of Surgery, University of Chicago Medical Center and Pritzker School of Medicine, Chicago, Illinois 60637, USA. drosen@surgery.bsd.uchicago.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Rosen
authors.forename: John E
authors.initials: JE
authors.lastname: O'Toole
authors.forename: Kurt M
authors.initials: KM
authors.lastname: Eichholz
authors.forename: Melody
authors.initials: M
authors.lastname: Hrubes
authors.forename: Dezheng
authors.initials: D
authors.lastname: Huo
authors.forename: Faheem A
authors.initials: FA
authors.lastname: Sandhu
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology / Q000517:prevention & control*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D013128:Spinal Osteophytosis / Q000150:complications / Q000601:surgery*; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome