[Common lumbosciatic syndrome of the elderly. Report of 67 cases].
BACKGROUND
The common lombosciatic is a disease observed at all ages. To the elderly, clinical data, treatment, clinical outcome and prognosis present sometimes some peculiarities.


OBJECTIVE
Report of lombosciatic in the elderly.


METHODS
It is a retrospective study including 67 cases of sciatica concerning old patients over 65 years presenting with common lombosciatica, hospitalized between January the 1-st, 2000 and December 31 st, 2004.


RESULTS
The mean age of our patients is of 71.2 years, sex ratio female/male of 1.88. A chronic lumbago is found at 16.34% of our patients and a starting factor pains in 14.3% of cases. Pain is of progressive installation in 93.4 % of cases. Mechanical in 77.5 % of cases and impulsive in 55 % of cases. Sciatica was unilateral in 67.3% of cases and interesting the root L 5 in 40.8 % of cases. Physical exam find a painless attitude in 26.5% of cases and a spasm of spinal muscles in 65.3%. The average of schöber index is of 2.4 cms + 1.18. Lasègue is present in 36.7 % of cases. Neurological exam find overdrawn signs in 8 % of cases, sensory signs in 61.2% of cases. No cauda equine syndrome was individualized in our series. Lumbar spine X-rays, made in 98 % of cases, show a L5-S1 disc impairment in 83.6% of cases, a scoliotic attitude in 22.4 % of cases, a spondylolithesis of L4L5 in 26,5 % of cases and lumbar cannal stenosis in 12.2% of cases. Lumbar densitometry, realized in 22.4% of cases, shows a herniated disc in 27.2% of cases, and a lumbar canal stenosis in 27.2% of cases. The MRI, made once, was normal. During their hospitalization, 87.7% of patients received NSAID's, 18.4% of them analgesics drugs (landing I, II , III) and 79.6 % epidurals infiltrations. All our patients observed bed rest. A physiotherapy was prescribed for 44.9 % of them. A good outcome was quickly noticed in 85.7% of the patients. A therapeutic failure was observed at 14.3 %. 6% underwent surgery. Only 102 % of the non operated patient had pain recurrence.


CONCLUSIONS
Nowadays sciatica is a frequent pathology either in oung or in geriatric population. Nevertheless it is necessary to eliminate a tumoral or infectious sciatica that can be misleading by the condition of the old age and by the frequent associated pathologies at such age.
Service de Rhumatologie la Rabta TUNIS, Bab Saadoun, Tunisie.
Elhem
E
Cheour
Wafa
W
Hamdi
Raoudha
R
Tekaya
Sami
S
Hamza
Samar
S
Kerkeni
Mohamed
M
Elleuch
Héla
H
Sahli
Mhondher
M
Khosrof
Slaheddine
S
Sellami
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D012585:Sciatica / Q000209:etiology* / Q000628:therapy*