Complications and Surgical Results of Operative Management for Spinal Stenosis in Elderly Patients

Se-Hun Kim; Jong-Hun Choi; Ho-Kook Lee; Jae-Gon Moon; Chang-Hyun Kim

doi:10.13004/jknts.2010.6.2.138

Journal List > J Korean Neurotraumatol Soc > v.6(2) > 1084067

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Kim, Choi, Lee, Moon, and Kim: Complications and Surgical Results of Operative Management for Spinal Stenosis in Elderly Patients

Clinical Article

Journal of Korean Neurotraumatology Society 2010; 6(2): 138-142.

Published online: 31 December 2010

DOI: https://doi.org/10.13004/jknts.2010.6.2.138

Complications and Surgical Results of Operative Management for Spinal Stenosis in Elderly Patients

Se-Hun Kim, MD, Jong-Hun Choi, MD, Ho-Kook Lee, PhD, Jae-Gon Moon, PhD, Chang-Hyun Kim, PhD

Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Address for correspondence: Jong-Hun Choi, MD. Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1 Daerim 1-dong, Yeongdeungpo-gu, Seoul 150-950, Korea. Tel: +82-2-829-5175, Fax: +82-2-833-0219, nscjh@hallym.or.kr

Received 2 September 2010 Revised 2 September 2010 Accepted 27 September 2010

Abstract

Objective

Spinal stenosis and spondylosis are major causes of morbidity among the elderly. Surgical decompression is an effective treatment, but elderly patients are not considered candidates for surgery, because of age and comorbidities. The aim of this study is to validate the safety and efficacy of surgical treatment of spinal stenosis in elderly patients by examining perioperative complication and surgical results.

Methods

Medical records of patients older than 70 years who underwent spinal stenosis surgery were retrospectively reviewed. For investigation of relationship between comorbidities and complications, comorbid medical illnesses were analyzed using Charlson Comorbidity index score. Data gathered included intraoperative and postoperative complications and surgical results. Complications were classified as the surgical and systemic (anesthetic, cardiopulmonary, and thromboembolic). Surgical results were evaluated change of VAS score and ambulatory functions.

Results

From 2000 to 2009, 56 patients were included. Forty patients were women and average follow-up period was 22.5±3.72 months. Surgical complications occurred in 6 patients (10.7%) and systemic complications were occurred in 3 patients (5.4%). The age and Charlson Comorbidity index score were not predictive of complications. The average operation time and the number of operated level were predictive of the risk of complications. Visual analogue scale score was decreased from 8.0±1.12 to 4.2±1.13. For patients' satisfaction and change of ambulatory function, 7 patients were in excellent, 36 patients were in good, and 11 and 2 patients were in fair and poor grade respectively.

Conclusion

If operation time could be saved, the surgical treatment would have effects in the elderly patients without complications even with comorbid diseases.

Keywords: Spinal stenosis, Laminectomy, Complication, Old age

Figures and Tables

TABLE 1

Summary of the Charlson Comorbidity Index

The total score is obtained by adding the relative weight of each comorbidity. AIDS: acquired immune deficiency syndrome

TABLE 2

Summary of patients' clinical finding

TABLE 3

Summary of perioperative comorbidity

DM: diabetes mellitus

TABLE 4

Summary of postoperative complication

CSF: cerebrospinal fluid

TABLE 5

Summary of factors associated with the presence/absence of complications

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