Minimally invasive spinal decompression in patients older than 75 years of age: Perioperative risks, complications and clinical outcomes compared with patients younger than 45 years of age

Minimally invasive spinal decompression in patients older than 75 years of age: Perioperative risks, complications and clinical outcomes compared with patients younger than 45 years of age

Abstract Purpose Minimally invasive spinal decompression for the treatment of spinal stenosis or disc herniation is often indicated if conservative management fails. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood. We therefore...

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Bibliographic Details
Published in:World neurosurgery Vol. 89; pp. 337 - 342
Main Authors: Khashan, M, Lidar, Z, Salame, K, Mangel, L, Lador, R, Drexler, M, Sapirstein, E, Regev, G.J
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-05-2016
Subjects:
Adolescent
Adult
Age Factors
Aged
Clinical outcomes
Comorbidity
Complications
Decompression, Surgical - adverse effects
Decompression, Surgical - methods
Elderly patients
Female
Follow-Up Studies
Humans
Male
Minimally invasive
Minimally Invasive Surgical Procedures - adverse effects
Minimally Invasive Surgical Procedures - methods
Neurosurgery
Postoperative Complications
Risk Factors
Spinal decompression
Spine - surgery
Treatment Outcome
Young Adult
elderly patients
EQ-5D
complications
VAS
minimally invasive
spinal decompression
EuroQol- 5 Dimension
ASA
Visual analog scale
LOS
clinical outcomes
Minimally invasive surgery
MIS
American Society of Anesthesiologists score
length of stay
SPSS
Statistical Package for Social Sciences
Complications
Spinal decompression
Minimally invasive
Elderly patients
Clinical outcomes
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Summary:Abstract Purpose Minimally invasive spinal decompression for the treatment of spinal stenosis or disc herniation is often indicated if conservative management fails. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood. We therefore, sought to compare complication rates and outcomes following MIS decompression and discectomy in the elderly patients with a cohort of young patients undergoing similar procedures. Methods We evaluated medical records of 61 patients older than 75 years and 69 patients younger than 45 years that underwent minimally invasive lumbar decompression between April 2009 and July 2013 at our institute. Past medical history, the American Society of Anesthesiologists (ASA) score, perioperative mortality, complication and revision surgeries rates were analyzed. Patient outcomes included: the visual analog scale (VAS) and the EQ-5D score. Results The average age was 78.66 ± 4.42 years in the elderly group and 33.59 ± 6.7 years in the young group. No major postoperative complications were recorded in either group, and all recruited patients were still alive at the time of the last follow-up. No statistically significant difference existed in the surgical revision rate between the groups. Both groups showed significant improvement in their outcome scores following surgery. Conclusions Our results indicate that minimally invasive decompressive surgery is a safe and effective treatment for elderly patients and does not pose an increased risk of complications. Future prospective studies are necessary to validate the specific advantages of the minimally invasive techniques in the elderly population.
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ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2016.02.018