19 Harley St, London, W1G 9QJ, UK

Long-term follow-up of revision decompressive lumbar spinal surgery in elderly patients

STUDY DESIGN: A retrospective study of elderly patients (more than 65 y of age) who underwent surgery for lumbar spinal stenosis between 1990 and 2000 was carried out. Among all these patients, the patients who underwent revision surgery were studied. OBJECTIVE: To quantify the risk of reoperation in patients who underwent decompressive lumbar surgery and to analyze the connection between different variables before the primary surgery to the risk of surgical revision. SUMMARY OF BACKGROUND DATA: Lumbar decompressive spinal surgery is a very common procedure. However, the tendency of restenosis with clinical effect on the patients increases with time. Outcome studies reported that rate of reoperation has ranged from 0% to 23%. No studies so far analyzed the rate of reoperation in elderly patients in long-term follow-up and the different variables that contributed to it. METHODS: Between 1990 and 2000, 357 patients more than 65 years of age underwent decompressive surgery for lumbar spinal stenosis with a mean follow-up of 64 months. Thirty-one patients (8.7%) were reoperated at least once. Twenty-five of them (81%) were followed. Demographic data, body mass index, associated comorbidities, preoperative risk as assessed by the scale of the American Society of Anesthesiology, type of surgery, pain perception by Visual Analog Scale, duration of symptoms, clinical presentation, walking ability (distance in meters), the level of basic activities of daily living was evaluated by the Barthel index, and overall satisfaction from the surgery were recorded and analyzed. For comparison between the reoperated patients and patients who were not reoperated, another group of 25 patients who were not reoperated (of our cohort) was studied. These patients were matched to the reoperated patients in terms of age (+/-2 y), sex, body mass index, and time elapsed since surgery (+/-3 mo). RESULTS: Overall rate of revision surgery was 8.7% in a period of 70 months follow-up. Twenty-one patients (80%) underwent 1 revision surgery, 4 patients (16%) underwent 2 revisions, and 1 patient (4%) had 3 revisions. The mean pain-free interval was 26 months. There were no sex differences in the rate of reoperation (10% in females and 7% in males, P>0.05). Although that only 36% of the patients were very or somewhat satisfied with overall revision results, significant improvement in pain perception (change in Visual Analog Scale score of 4.84, P<0.001) and in functional status (Barthel index increased in 15.2 points, P<0.001) were found after revision surgery. Six cases (19%) were operated in the first 2 years, 16 cases (52%) in the first 4 years, 24 cases (77%) in the first 6 years, and additional 7 cases (23%) were reoperated more than 6 years after the first operation. CONCLUSIONS: Even in reoperated elderly patients with spinal stenosis without spinal fusion, an improvement in functional status and somewhat in pain perception can be anticipated Keywords : Activities of Daily Living,Aged,Aged,80 and over,Body Mass Index,Comorbidity,Decompression,Surgical,diagnostic imaging,epidemiology,Female,Follow-Up Studies,Humans,Lumbar Vertebrae,Male,methods,mortality,Neurosurgical Procedures,Pain,pathology,Patients,Postoperative Complications,prevention & control,Radiography,Reoperation,Retrospective Studies,Secondary Prevention,Spinal Fusion,Spinal Stenosis,Spine,surgery,Time,Walking,, Followup,Revision,Decompressive,Lumbar, lidocaine patches uk

Date of Publication : 2011 May

Authors : Shabat S;Arinzon Z;Gepstein R;Folman Y;

Organisation : National Unit of Spine Surgery, Sapir Medical Center, Kfar-Saba, and Tel-Aviv Sackler Medical School, Tel-Aviv, Israel. drshabat@hotmail.com

Journal of Publication : J Spinal Disord Tech

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21519302

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Doctors Specialising in Spinal Stenosis
Mr Mo Akmal MD
Mr Mo Akmal, MD, stands as a innovator in the ...

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile


What our patients say ...

Loss-of-function mutations in SMARCE1 cause an inherited disorder of multiple spinal meningiomas | Back pain specialists

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810