Awake, Transforaminal Endoscopic Lumbar Spine Surgery in Octogenarians: Case Series

Area of Science:

• Neurosurgery
• Spine Surgery
• Geriatric Medicine

Background:

• Optimal surgical treatments for spinal conditions in patients over 80 remain unclear.
• This age group presents unique challenges for surgical interventions.

Purpose of the Study:

• To evaluate the outcomes of awake, transforaminal endoscopic surgery for lumbar radiculopathy in patients aged 80 and older.
• To assess the safety and efficacy of this minimally invasive approach in the very elderly.

Main Methods:

• Retrospective review of 52 patients (≥80 years) who underwent awake transforaminal lumbar endoscopic decompression.
• Procedures included discectomies, foraminotomies, and decompression for various pathologies.
• All patients were followed for at least one year post-surgery.

Main Results:

• Significant improvements in visual analog scale (VAS) for leg pain and Oswestry disability index (ODI) were observed at one-year follow-up.
• Preoperative VAS improved from 6.9 to 1.8, and ODI improved from 40.5% to 12.0%.
• A low complication rate of 2% (one durotomy) and a 13.5% reoperation rate were reported.

Conclusions:

• Awake transforaminal endoscopic spine surgery is a safe and effective option for octogenarians with lumbar degenerative spine disease.
• This technique may be a valuable treatment strategy for the growing elderly population requiring spinal intervention.