There is a healthy fear of spine surgery, especially in the senior citizen population. At the same time, so many are in such pain, there is a willingness to have spine surgery. Luckily, there is evidence that Spine Surgery is safe for the over 80 year old population.
In the February 4, 2015 edition of the Journal of Bone and Joint Surgery (http://jbjs.org/content/97/3/177), Dr. Rihn et al presented “Effectiveness of Surgery for Lumbar Stenosis and Degenerative Spondylolithesis in the Octogenarian Population”.
To summarize the findings, the Spine Patient Outcomes Research Trial data was analysed comparing the results of spinal stenosis and spondylolithesis surgery patients younger than 80 years of age, to those 80 years and older.
58 patients greater than 80 years olds had surgery. 749 patients younger than 80 years had surgery. When comparing the results, both groups had significant benefit from surgery. Most importantly, the older group did not have any greater a risk for complications.
Highlights of the data show the older population to have higher rates of high blood pressure, heart problems, and bone problems. The older population, however, were thinner, smoked less, and had less depression.
Analysis of the surgeries performed, indicated the older population had more simple laminectomies (“removal of bone spurs”), and less bone fusions.
To be fair to the study, the results were similar, but the types of surgeries performed, and the type of patients that had surgery was different.
For the over 80 years old crowd, it is still good news. If you have severe stenosis, and do not improve with non-surgical care, surgery may still be an option. Ultimately, you and your surgeon must match the surgical option to your complaints, test results, and your current medical conditions. Prudent surgeons will still weigh the risks versus the potential benefits. By this data, at least it does not show any significant increased risk for properly selected individuals.
- Rihn JA, Hilibrand AS, Zhao W, Lurie JD, Vaccaro AR, Albert TJ, Weinstein J. Effectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data. J Bone Joint Surg Am. 2015 Feb 4;97(3):177-85. PubMed PMID: 25653317