title: Minimally Invasive Spinal Decompression in Patients Older Than 75 Years of Age: Perioperative Risks, Complications, and Clinical Outcomes Compared with Patients Younger Than 45 Years of Age.
abstract: OBJECTIVE
  Minimally invasive spinal decompression for the treatment of spinal stenosis or disk herniation is often indicated if conservative management fails. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood. We therefore sought to compare complication rates and outcomes after minimally invasive surgery decompression and discectomy in elderly patients with a cohort of younger patients undergoing similar procedures.
  
  
  METHODS
  We evaluated medical records of 61 patients older than 75 years and 69 patients younger than 45 years that underwent minimally invasive lumbar decompression between April 2009 and July 2013 at our institute. Medical history, American Society of Anesthesiologists score, perioperative mortality, complications, and revision surgery rates were analyzed. Patient outcomes included visual analog scale and EuroQol-5 Dimension scores.
  
  
  RESULTS
  The average age was 78.66 ± 4.42 years in the elderly group and 33.59 ± 6.7 years in the younger group. No major postoperative complications were recorded in either group, and all recruited patients were still alive at the time of the last follow-up. No statistically significant difference existed in the surgical revision rate between the groups. Both groups showed significant improvement in their outcome scores after surgery.
  
  
  CONCLUSIONS
  Our results indicate that minimally invasive decompressive surgery is a safe and effective treatment for elderly patients and does not pose an increased risk of complications. Future prospective studies are necessary to validate the specific advantages of the minimally invasive techniques in the elderly population.
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Orthopaedic Surgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Morsi
authors.initials: M
authors.lastname: Khashan
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Zvi
authors.initials: Z
authors.lastname: Lidar
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Khalil
authors.initials: K
authors.lastname: Salame
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Laurence
authors.initials: L
authors.lastname: Mangel
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Orthopaedic Surgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Lador
authors.affiliation: Department of Orthopaedic Surgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Drexler
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Eilat
authors.initials: E
authors.lastname: Sapirstein
authors.affiliation: Department of Neurosurgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Orthopaedic Surgery, The Spine Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Electronic address: gregev@gmail.com.
authors.forename: Gilad J
authors.initials: GJ
authors.lastname: Regev
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications; D012307:Risk Factors; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Clinical outcomes; Complications; Elderly patients; Minimally invasive; Spinal decompression