Long-term outcome of laminectomy for spinal stenosis in octogenarians

Study Design. Cohort study with follow-up after at least 1.5 years. Objectives. The purpose of this study was to determine long-term safety and efficacy of laminectomy in octogenarians. Summary of Background Data. This is the first study evaluating the outcome in octogenarians with well-defined lumbar spinal stenosis. This study was designed to provide some guidance in clinical-practical decisions in the treatment of aged patients with lumbar stenosis. Methods. We evaluated long-term outcome after laminectomy in 23 consecutive patients affected by lumbar spinal stenosis. Comorbidity was assessed using the Cumulative Illness Rating Scale for Geriatrics. At follow-up, all patients completed a questionnaire containing the Visual Analog Pain Scale and the Oswestry Disability Index. The use of analgesics was assessed from chart review of their family physician. Results. The average age at the time of surgery was 82.2 +/- 2.6 years; the mean follow-up was 2.7 +/- 1.2 years. The mean of the Cumulative Illness Rating Scale for Geriatrics total score was 7.7 +/- 4.3, reflecting the normative comorbidity-values of octogenarians. At follow-up, 4 patients had died. The Oswestry Disability Index for the remaining patients was 36.4 +/- 28%. The daily nonsteroidal anti-inflammatory medication had decreased from 1.9 to 0.1 equivalent analgesic doses and the amount of morphine from 0.6 to 0.2 equivalent narcotic doses. The Pain Score on the Visual Analog Pain Scale decreased from 85 to 39. After surgery no patient had claudication. Conclusion. On the long-term, decompressive laminectomy in selected octogenarians results in decreased disability, decline of analgesics usage, and increased quality of life.