Complications of spinal surgery for elderly patients with lumbar spinal stenosis in a super-aging country: An analysis of 8033 patients

Abstract Background Although percutaneous endoscopic lumbar discectomy (PELD) is increasingly being used to treat lumbar degenerative disease, the treatment of elderly patients with lumbar spinal stenosis (LSS) involves considerable uncertainty. The purpose of this study was to evaluate the safety and effectiveness of PELD for the treatment of LSS in elderly patients aged 65 years or older. Methods In this retrospective review, 136 patients aged 65 years or older who underwent PELD to treat LSS were evaluated. The patients were divided into two groups, group A (ages 65–74) and group B (age ≥ 75), and perioperative data were analyzed. The Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and MacNab classification were used to evaluate postoperative clinical efficacy. Results All patients successfully underwent the operation with satisfactory treatment outcomes. Compared to preoperative scores, the self-reported scores or pain while performing daily activities were significantly improved in both treatment groups (P < 0.05). No statistically significant between-group differences were observed in operation time, intraoperative blood loss, postoperative bed rest, and postoperative hospital stay (P > 0.05). The overall postoperative complication rate was similar between the two groups. Moreover, no statistically significant differences in VAS-back pain scores, VAS-leg pain scores, JOA scores, and MacNab classification were found between the groups at the 3-month and 1.5-year follow-up examinations (P > 0.05). Conclusion PELD is safe and effective for the treatment of LSS in elderly patients. Age is not a contraindication for decompressive lumbar spine surgery. PELD has advantages such as reduced trauma, fewer anesthesia-related complications, and a fast postoperative recovery. Elderly patients should be considered good candidates for lumbar decompression surgery using minimally invasive techniques.

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Two cases of lumbar spinal stenosis with lumbar spondylolisthesis in elderly patients who benefited from spinal cord stimulation and an electrophysiological diagnosis

Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics ◽

10.3143/geriatrics.58.617 ◽

2021 ◽

Vol 58 (4) ◽

pp. 617-623

Author(s):

Nobukiyo Sumi

Keyword(s):

Spinal Cord ◽

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Cord Stimulation ◽

Lumbar Spinal ◽

Lumbar Spondylolisthesis

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Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2019.54.3.219 ◽

2019 ◽

Vol 54 (3) ◽

pp. 219

Author(s):

Taewook Kang ◽

Soon Hyuck Lee ◽

Si Young Park

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Surgery ◽

Lumbar Spinal ◽

Endoscopic Spinal Surgery

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Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?

Medicine ◽

10.1097/md.0000000000015451 ◽

2019 ◽

Vol 98 (18) ◽

pp. e15451 ◽

Cited By ~ 10

Author(s):

Taewook Kang ◽

Si Young Park ◽

Chun Hyung Kang ◽

Soon Hyuck Lee ◽

Jong Hoon Park ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Surgery ◽

Lumbar Spinal ◽

Endoscopic Spinal Surgery

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Biportal endoscopic spinal surgery for lumbar spinal stenosis

Ukrainian Neurosurgical Journal ◽

10.25305/unj.187535 ◽

2020 ◽

Vol 26 (1) ◽

pp. 13-19

Author(s):

Iakiv V. Fishchenko ◽

Lyudmyla D. Kravchuk

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Surgery ◽

Lumbar Spinal ◽

Endoscopic Spinal Surgery

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Surgical Management of Lumbar Spinal Stenosis in Patients Over 80 : Is There an Increased Risk ?

10.21203/rs.3.rs-1017167/v1 ◽

2021 ◽

Author(s):

frédérick rault ◽

Anaïs R Briant ◽

Thomas Gaberel ◽

Hervé Kamga ◽

Evelyne Emery

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Heart Diseases ◽

The Elderly ◽

Lumbar Spine Surgery ◽

Increased Risk ◽

History Of ◽

Lumbar Spinal

Abstract Introduction:Management of lumbar spinal stenosis (LSS) represents the first cause of spinal surgery for the elderly and will increase with the aging population. Although the surgery improves quality of life, the procedure involves anaesthetic and operative risks. The aim of this study was to assess whether the postoperative complications rate was higher for elderly patients and to find confounding factors.Material and MethodsWe conducted a retrospective study including all LSS surgeries between 2012 and 2020 at the University Hospital of Caen. We compared two populations opposing patients aged over 80 with others. The primary endpoint was the occurrence of a severe complication (SC). Minor complications were the secondary endpoint. Comorbidities, history of lumbar spine surgery and surgical characteristics were recorded.Results996 patients undergoing surgery for degenerative LSS were identified. Patients over 80 were significantly affected by additional comorbidities: hypertension, heart diseases, higher age-adjusted comorbidity Charlson score, ASA score and use of anticoagulants. Knee-chest position was preferred for younger patients. Older patients underwent a more extensive decompression and had more incidental durotomies. 5.2% of patients presented SC. Age over 80 did not appear to be a significant risk factor for SC, but minor complications increased. Multivariate analysis showed that heart diseases, history of laminectomy, AA-CCI, and accidental durotomies were independent risk factors for SC.ConclusionSurgical management for lumbar spinal stenosis is not associated to a higher rate of severe complications for patients over 80 years of age. However, preoperative risk factors should be investigated to warn the elderly patients that the complications risk is increased although an optimal preparation is the way to avoid them.

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Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

10.21203/rs.3.rs-25682/v1 ◽

2020 ◽

Author(s):

Yi Liu ◽

Yingjie Qi ◽

Diarra Mohamed Diaty ◽

Guanglei Zheng ◽

Xiaoqiang Shen ◽

...

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Disease Duration ◽

Ligamentum Flavum ◽

Leg Pain ◽

Control Group ◽

Interlaminar Approach ◽

Lumbar Spinal ◽

Percutaneous Endoscopy

Abstract Background This paper is to first describe percutaneous endoscopy in the treatment of lumbar spinal stenosis secondary to ligamentum flavum hypertrophy targetedly. To investigate the efficacy and safety of percutaneous endoscopy in the treatment of this kind of lumbar spinal stenosis in elderly patients. Method: A retrospective analysis of 40 elderly patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy admitted between January 2016 and January 2018 was performed. According to different surgical methods, they were divided into two groups: the control group and the endoscopy group (interlaminar approach), 20 people per group. There were 9 males and 11 females in the control group; the age of patients was 65.65 ± 4.44years, and the average disease duration was 4.55 ± 1.85 years. Besides, There were 10 males and 10 females in the endoscopy group; the age of patients was 67.30 ± 4.23years, and the average disease duration was 4.95 ± 2.04 years. Collect and count surgical-related indicators, preoperative and postoperative radiologic findings, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores of all patients. Result A series of surgical indicators (including the operation time, the quantity of bleeding and postoperative hospital stay) in the endoscopy group was significantly lower than that in the control group (p < 0.05). The incision VAS score in the endoscopy group was also significantly lower than that in the control group at each time after surgery (p < 0.05). Besides, compared with the control group, in the endoscopy group, the leg pain VAS score and lumbar ODI score after surgery were significantly decreased (p < 0.05). Compared with the control group, in the endoscopy group, the lumbar JOA score was significantly higher (p < 0.05). Conclusion Percutaneous endoscopic technique is a small trauma, quick recovery, safe and effective minimally invasive surgery for patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy.

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