Clinical Analysis of Lumbar Herniation in the Elderly Patients / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A retrospective analysis of lumbar disc herniation in elderly patients. OBJECTIVES: To evaluate the clinical picture and surgical outcome of a lumbar disc herniation in elderly patients. SUMMARY OF LITERATURE REVIEW: Lumbar disc herniation is less common in older persons, but there has been an increasing concern in elderly patients. MATERIALS AND METHODS: A retrospective review evaluated 34 patients (men:12, female:22) over 65 years old or with a T score -2.5 or below below on the BMD and/or over 60 years old with systemic comorbid disease who underwent surgery for a lumbar disc herniation between January 1991 and June 2001. All patients had at least a 2-year follow-up evaluation. They were analyzed for their physical status, comorbid condition, preoperative, follow-up symptoms and signs, the long-term clinical outcome based on the ASA (American society of anesthesiology) class and operative findings. RESULTS: There were 7 ASA class I patients, 22 ASA class II patients, 5 ASA class III patients, and comorbidity was found in 20 patients. Higher rates of negative straight leg raising were observed in the elderly patients compared to the younger patients, and 8 patients had a neurological claudication history. 25 patients had excellent or good results and better results were obtained with the sequestration and extrusion type, respectively, as compared with protrusion type. However, there was no correlation between the ASA class, postoperative complications, and clinical outcome. CONCLUSIONS: Clinical picture of disc herniation in the elderly patients may be nonspecific. Therefore, it is believed that the surgical indication is different from young patients, and requires a proper examination and diagnosis.