Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study

• Published in: Journal of orthopaedic surgery and research Vol. 15; no. 1; pp. 1 - 441
• Main Authors: Li, Hua, Ou, Yufu, Xie, Furong, Liang, Weiguo, Tian, Gang, Li, Hongyu
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 24.09.2020; BioMed Central; BMC
• Subjects: Age; Anesthesia; Back pain; Bone surgery; Calcification; Care and treatment; Classification; Decompression; Elderly; Elderly patients; Endoscopy; Hospitals; Immobilization; Interlaminar approach; Local anesthesia; Lumbar spinal stenosis (LSS); Magnetic resonance imaging; Medical research; Orthopedics; Pain; Patients; Percutaneous endoscopic lumbar discectomy (PELD); Spinal stenosis; Spine (lumbar); Statistical analysis; Surgery; Transforaminal approach; Trauma; Vertebrae; China
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-020-01968-0

Abstract Background Although percutaneous endoscopic lumbar discectomy (PELD) is increasingly being used to treat lumbar degenerative disease, the treatment of elderly patients with lumbar spinal stenosis (LSS) involves considerable uncertainty. The purpose of this study was to evaluate the safety and effectiveness of PELD for the treatment of LSS in elderly patients aged 65 years or older. Methods In this retrospective review, 136 patients aged 65 years or older who underwent PELD to treat LSS were evaluated. The patients were divided into two groups, group A (ages 65–74) and group B (age ≥ 75), and perioperative data were analyzed. The Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and MacNab classification were used to evaluate postoperative clinical efficacy. Results All patients successfully underwent the operation with satisfactory treatment outcomes. Compared to preoperative scores, the self-reported scores or pain while performing daily activities were significantly improved in both treatment groups ( P < 0.05). No statistically significant between-group differences were observed in operation time, intraoperative blood loss, postoperative bed rest, and postoperative hospital stay ( P > 0.05). The overall postoperative complication rate was similar between the two groups. Moreover, no statistically significant differences in VAS-back pain scores, VAS-leg pain scores, JOA scores, and MacNab classification were found between the groups at the 3-month and 1.5-year follow-up examinations ( P > 0.05). Conclusion PELD is safe and effective for the treatment of LSS in elderly patients. Age is not a contraindication for decompressive lumbar spine surgery. PELD has advantages such as reduced trauma, fewer anesthesia-related complications, and a fast postoperative recovery. Elderly patients should be considered good candidates for lumbar decompression surgery using minimally invasive techniques.