title: Decompression surgery for lumbar spinal canal stenosis in octogenarians; a single center experience of 121 consecutive patients.
abstract: BACKGROUND
  With increasing age, ubiquitous degeneration processes lead to a narrowing of the spinal canal. Degenerative lumbar spinal stenosis (DLSS) causes functional disability and is associated with back and lower extremity pain in older individuals. The goal of this study was to determine if decompression surgery can be performed safely and provide a stable benefit in our octogenarian patient population.
  
  
  METHODS
  In this retrospective study, 121 patients over the age of 80 (mean age: 82.7 years SD: 2.4 years) with the diagnosis of central spinal canal stenosis who underwent posterior decompression surgery without fusion for DLSS between January 2006 and August 2013 were followed up from November to December 2013. Peri- and post-operative complications were recorded. Walking distances and visual analogue scale (VAS) scores were determined before surgery and at follow up time (mean follow up time 36 months). Patient's satisfaction with treatment was documented with the overall satisfaction degree scale in Zurich Claudicatio Questionnaire (ZCQ).
  
  
  RESULTS
  The peri-operative complication rate was 6.6% with five dural tears, two wound infections and one epidural haematoma. Four patients required revision surgery (three re-decompression and one secondary spondylodesis). Walking distance improved from 147 meters (SD ±110 m) to 340 m (SD ±170 m) p < .001. Pain improved with change of the VAS scores from 7.2 (SD ±1.2) to 4.5 (SD ±1.0), p < .001. The overall satisfaction scale in ZCQ was 2.2 at follow up.
  
  
  CONCLUSIONS
  A minimal surgical intervention, namely decompression, improves walking ability, decreases pain and has marginal potential for complications in patients with DLSS who are over 80 years old.
authors.affiliation: a Department of Orthopedics , University Hospital Balgrist, University of Zurich , Zurich , Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Antoniadis
authors.affiliation: a Department of Orthopedics , University Hospital Balgrist, University of Zurich , Zurich , Switzerland.
authors.forename: Nils H
authors.initials: NH
authors.lastname: Ulrich
authors.affiliation: a Department of Orthopedics , University Hospital Balgrist, University of Zurich , Zurich , Switzerland.
authors.forename: Samuel
authors.initials: S
authors.lastname: Schmid
authors.affiliation: a Department of Orthopedics , University Hospital Balgrist, University of Zurich , Zurich , Switzerland.
authors.forename: Mazda
authors.initials: M
authors.lastname: Farshad
authors.affiliation: a Department of Orthopedics , University Hospital Balgrist, University of Zurich , Zurich , Switzerland.
authors.forename: Kan
authors.initials: K
authors.lastname: Min
mesh_terms: D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking
keywords: Spinal canal stenosis; decompression surgery; lumbar back pain; octogenarian