[Surgical treatment of the degenerative lumbar spine in ild age]

Degenerative lumbar spine conditions, mostly combinations of spinal stenosis, instability, deformity and arthrosis, threaten the independence of elderly patients due to intractable pain and loss of function. Comprehensive operative treatment is possible, but is often not offered to these patients. The reasons are: fear of an unsuccessful outcome, fear of fatal complications and underestimation of the remaining life span. The literature shows that good results can be obtained in approximately 80% as well in one- and two-level degenerations as in multisegmental deformities. Perioperative mortality is about zero, but the the costs are high, approximately twice as much as for a total hip replacement. The single most frequent complication in 50 patients over 70 years was temporary cerebral problems. With adequate precautions the gain in quality of life outweighs the risks and costs.