Lumbar disc herniation in the elderly: a rare and rewarding object for surgery

We carried out a four to twelve year follow-up study in thirteen patients aged 63 years and over who were operated on for lumbar disc herniation. In eleven cases the herniation was at the L 4-5 level and in two at the L 5--S 1 level. Additional bony entrapment was present in eight cases. Simple disc removal through a small laminotomy was performed in eight patients, with a good or excellent result in four cases. Disc removal through a hemilaminectomy or laminectomy with the necessary lateral decompression of the bony entrapment gave a good or excellent result in each of the five patients. It is concluded that disc operation in the elderly usually gives acceptable late results. When even a minor bony stenosis is present at the disc herniation level, hemilaminectomy or even laminectomy should be considered.