title: Outcome and Complications in Surgical Treatment of Lumbar Stenosis or Spondylolisthesis in Geriatric Patients.
abstract: Development of anesthesiology and improvement of surgical instruments enabled aggressive surgical treatment even in elderly patients, who require more active physical activities than they were in the past. However, there are controversies about the clinical outcome of spinal surgery in elderly patients with spinal stenosis or spondylolisthesis. The purpose of this study is to review the clinical outcome of spinal surgery in elderly patients with spinal stenosis or spondylolisthesis. MEDLINE search on English-language articles was performed. There were 39685 articles from 1967 to 2013 regarding spinal disease, among which 70 dealt with geriatric lumbar surgery. Eighteen out of 70 articles dealt with geriatric lumbar surgery under the diagnosis of spinal stenosis or spondylolisthesis. One was non-randomized prospective, and other seventeen reports were retrospective. One non-randomized prospective and twelve out of seventeen retrospective studies showed that old ages did not affect the clinical outcomes. One non-randomized prospective and ten of seventeen retrospective studies elucidated postoperative complications: some reports showed that postoperative complications increased in elderly patients, whereas the other reports showed that they did not increase. Nevertheless, most complications were minor. There were two retrospective studies regarding the mortality. Mortality which was unrelated to surgical procedure increased, but surgical procedure-related mortality did not increase. Surgery as a treatment option in the elderly patients with the spinal stenosis or spondylolisthesis may be reasonable. However, there is insufficient evidence to make strong recommendations regarding spinal surgery for geriatric patients with spinal stenosis and spondylolisthesis.
authors.affiliation: Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Medical College of Hallym University, Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Anyang, Korea.
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Anyang, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Anyang, Korea. amhangpark@gmail.com.
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D010361:Patients; D011183:Postoperative Complications / Q000175:diagnosis; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome
keywords: Spinal surgery; geriatric patient; spinal stenosis; spondylolisthesis