J Korean Soc Spine Surg.  2004 Sep;11(3):147-153. 10.4184/jkss.2004.11.3.147.

Clinical Analysis of Lumbar Herniation in the Elderly Patients

• Shim DM
• Lee BC
• Kim TK
• Ha DH
• Kim YJ
• Park JY
• Kim JY

• KMID: 1839985
• DOI: http://doi.org/10.4184/jkss.2004.11.3.147

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.

Keyword

Elderly Patient; disc Herniation; Therapy

MeSH Terms

Aged*
Comorbidity
Diagnosis
Follow-Up Studies
Humans
Leg
Middle Aged
Postoperative Complications
Retrospective Studies

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