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

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 a...

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Main Authors: Hua Li, Yufu Ou, Furong Xie, Weiguo Liang, Gang Tian, Hongyu Li
Format: Article
Language:English
Published: BMC 2020-09-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-020-01968-0
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author Hua Li
Yufu Ou
Furong Xie
Weiguo Liang
Gang Tian
Hongyu Li
author_facet Hua Li
Yufu Ou
Furong Xie
Weiguo Liang
Gang Tian
Hongyu Li
author_sort Hua Li
collection DOAJ
description 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.
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spelling doaj.art-e6feed610db545b0abb3040b2c0898132022-12-22T02:10:19ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-09-011511910.1186/s13018-020-01968-0Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective studyHua Li0Yufu Ou1Furong Xie2Weiguo Liang3Gang Tian4Hongyu Li5Department of Spine Surgery, Guangxi Orthopedics and Traumatology HospitalDepartment of Orthopaedics, People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Spine Surgery, Guangxi Orthopedics and Traumatology HospitalDepartment of Spine Surgery, Guangxi Orthopedics and Traumatology HospitalDepartment of Spine Surgery, Guangxi Orthopedics and Traumatology HospitalDepartment of Spine Surgery, Guangxi Orthopedics and Traumatology HospitalAbstract 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.http://link.springer.com/article/10.1186/s13018-020-01968-0Lumbar spinal stenosis (LSS)ElderlyPercutaneous endoscopic lumbar discectomy (PELD)Transforaminal approachInterlaminar approach
spellingShingle Hua Li
Yufu Ou
Furong Xie
Weiguo Liang
Gang Tian
Hongyu Li
Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
Journal of Orthopaedic Surgery and Research
Lumbar spinal stenosis (LSS)
Elderly
Percutaneous endoscopic lumbar discectomy (PELD)
Transforaminal approach
Interlaminar approach
title Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
title_full Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
title_fullStr Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
title_full_unstemmed Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
title_short Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study
title_sort linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients a retrospective study
topic Lumbar spinal stenosis (LSS)
Elderly
Percutaneous endoscopic lumbar discectomy (PELD)
Transforaminal approach
Interlaminar approach
url http://link.springer.com/article/10.1186/s13018-020-01968-0
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