Surgical therapy for degenerative lumbar spinal canal stenosis in the elderly

Objective To investigate the modality and outcome of surgical treatment for degenerative lumbar spinal canal stenosis in elderly patients. Methods From February 2003 to April 2006, a retrospective review of 137 cases of degenerative lumbar canal stenosis treated surgically was performed. They included 92 males and 45 females ranging in age from 70~81 years with a mean of 75.6 years, whose history ranged from 3 to 8 years with a mean of 5.3 years. Of these patients, 41 patients suffered from one or more types of morbus internus concomitantly. All patients had received medical treatment before surgical treatment. Surgical modalities included simple surgical decompression in 112 cases, and posterior decompression combined with pedicle screws fixation and posterolateral bone graft in the remaining 25 cases. All patients were followed up for 1.5-3.1 years. Results No death occurred. Perioperative complications occurred in 12 cases, which were relieved after symptiomatic treatment. Oswestry score improved from preoperative 62.42±11.36 to postoperative 17.25±5.62. The continuous motor function improved in all cases from no more than 15min preoperationally to at least 30min postoperationally. Conclusions Surgical intervention is of great significance in helping the recovery of neurological function of elderly patients with degenerative lumbar canal stenosis. Positive preoperative treatment of complications is helpful in reducing perioperative risks of such patients.