Neurospine.  2018 Jun;15(2):131-137. 10.14245/ns.1836046.023.

Feasibility of Full Endoscopic Spine Surgery in Patients Over the Age of 70 Years With Degenerative Lumbar Spine Disease

• Kim JH
• Kim HS
• Kapoor A
• Adsul N
• Kim KJ
• Choi SH
• Jang JS
• Jang IT
• Oh SH

• KMID: 2426319
• DOI: http://doi.org/10.14245/ns.1836046.023

Abstract

BACKGROUND/AIMS
Degenerative spine disease, encompassing disc prolapse and stenosis, is a common ailment in old age. This prospective study was undertaken to evaluate the role of endoscopic spine surgery in elderly patients (above 70 years of age) with clinical and radiological follow-up.
METHODS
In this study, a retrospective analysis was conducted of 53 patients with lumbar disc prolapse or spinal stenosis who were treated with percutaneous endoscopic discectomy or decompression from November 2015 to June 2017. Clinical follow-up was done at 1 week, 3 months, and 1 year, and at yearly intervals thereafter. The outcomes were assessed using the modified Macnab criteria, a visual analogue scale, and the Oswestry Disability Index.
RESULTS
Of the 53 patients, 21 were men and 32 were women. Their mean age was 76±4 years. The mean follow-up period was 17 months. Percutaneous endoscopic discectomy was performed in 24 patients and endoscopic decompression in 24 patients, while 5 patients underwent combined surgery. An excellent outcome in terms of the MacNab criteria was observed in 9 patients (16.98%), a good outcome in 38 patients (71.7%), and a poor outcome in 6 patients (11.3%). Of the 6 patients with a poor outcome, 5 (9.4%, 5 of 53) developed recurrent disc prolapse, and 1 developed hematoma with motor weakness. All 6 of these cases required revision surgery.
CONCLUSION
Managing degenerative spine disease in elderly patients with multiple comorbidities is a challenging task. Percutaneous endoscopic spine surgery is pivotal for addressing this concern. The authors have shown that optimal results can be achieved with various types of disc prolapse and stenosis with favorable long-term outcomes.

Keyword

Percutaneous endoscopic spine surgery; Old age; Disc prolapse; Stenosis; Decompression; Discectomy

MeSH Terms

Aged
Comorbidity
Constriction, Pathologic
Decompression
Diskectomy
Female
Follow-Up Studies
Hematoma
Humans
Male
Prolapse
Prospective Studies
Retrospective Studies
Spinal Stenosis
Spine*