For most patients, the natural course of a herniated lumbar disk is
favorable, and the consensus is that surgical treatment is offered if
the pain in the lower back and radiating down the legs persists despite a
period of conservative treatment.
Lumbar microdiskectomy is the most
common surgical treatment, but data on surgical outcomes among elderly
patients are limited.
‘Although patients 65 years of age or older had more minor complications and longer hospital stays, they experienced improvements in their conditions after lumbar microdiskectomy that were similar to those of younger patients.’
Although patients 65 years of age or older had more minor
complications and longer hospital stays, they experienced improvements
in their conditions after surgery for a herniated lumbar disk that were
similar to those of younger patients, according to a study published
online by JAMA Surgery
Sasha Gulati of St. Olavs University Hospital,
Trondheim, Norway and colleagues compared patient-reported outcomes
following lumbar microdiskectomy among 5,195 patients younger than 65
years of age and 381 patients 65 years of age or older. Data were
collected through the Norwegian Registry for Spine Surgery, a
comprehensive registry for quality control and research.
For all patients, there was a significant improvement in a measure of disability (Oswestry Disability Index; ODI).
There were no differences between age groups in average changes of
the ODI, health-related quality of life, or leg pain, but older patients
experienced more improvement in low back pain. Compared with patients
younger than 65 years of age, older patients experienced more
perioperative complications (4.2% vs 2.3%) and more
complications occurring within three months of hospital discharge (12.4% vs 5.4%), while younger patients had shorter hospital
stays (1.8 vs 2.7 days).
"Age alone should not be a contraindication to surgery, as long as the individual is fit for surgery," the authors write.