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[Characteristics of perioperative lumbar operation for the elderly]
1Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Objectives:
To study the characteristics of senile patients during perioperative lumbar operation and discuss matched surgical method.
Methods:
From 1998 to 2000, lumbar operations were performed in 41 elderly patients (average age 68). 14 patients had lumbar disc herniation, 11 lumbar disc herniation with lumbar spinal stenosis, 12 lumbar instability and spondylolisthesis, 2 reoperation, and 2 combined compression of cervicle and thoracic spinal cord.
Results:
Many patients were complicated by the following diseases: hypertension (14), coronary heart disease (9), diabetes mellitus (4), cerebral infarction (3), rheumatic heart disease (1), pulmonary heart disease (1), and complicated with 2 or 3 diseases (9). Discectomy was performed in 14 patients, decompression + discectomy in 11, posterior lateral fusion with pedicle instrument in 9, posterior lateral intravertebrae fusion with instrument in 3. Fixation of 2 levels was made in 5 patients, 3 levels in 3, and multi-levels in 2. Postoperation JOA amelioration rate was 81.6%.
Conclusion:
The condition of adjacent segment should be considered in the operative treatment of elderly patients. Caution should also be taken to coexisting diseases.