Long-term outcome of decompressive surgery for lumbar spinal stenosis in octogenarians.
The purpose of our prospective study is to evaluate the surgical outcome among patients aged 80 years and above, who underwent surgery for lumbar spinal stenosis. We assessed patients' clinical and demographic data, procedures, perioperative complications, preoperative and postoperative pain intensity, basic activities of daily living (BADL), patients' satisfaction, the need for repeated surgery, and overall mortality. Thirty-nine patients more than 80 years of age were operated in our institution in the last decade. Twenty-five of them were followed-up with a mean 36.8 months after the operation. The Barthel index was used to evaluate pre and postsurgery ADL, and the visual analogue scale (VAS) was used to evaluate pain. The satisfaction rate of the patients before and after the operation and the complication rate were also evaluated. A significant reduction in VAS (P < 0.001) and a significant increase in the Barthel index (P < 0.001) were recorded. Seventy-six percent of the patients were very satisfied or somewhat satisfied with the operative results. Fifty-two percent of the patients had complications (0.9 complications per patients), however, about half of them were minor. No operative or perioperative mortality was noticed and the overall hospital stay for these elderly patients was 3.6 days on average. Surgery in very old elderly patients is safe and effective in the treatment of spinal stenosis, who did not respond well to the conservative treatment. The surgery did not increase the associated morbidity and mortality and most of the patients benefited from the surgery in terms of reduction in pain, increase in ADL and walking ability and overall increase in the satisfaction rate.
Shabat
Shay
S
Spinal Care Unit, Sapir Medical Center, 48 Tchernichovsky Street, Kfar-Saba, 44281, Israel.
Arinzon
Zeev
Z
Folman
Yoram
Y
Leitner
Josef
J
David
Rami
R
Pevzner
Evgeny
E
Gepstein
Reuven
R
Pekarsky
Ilya
I
Shuval
Ishay
I
D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D053208:Kaplan-Meier Estimate; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome