Older adults experience similar improvements following surgery for herniated lumbar disk

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.

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.

Sasha Gulati, M.D., Ph.D., 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 percent vs 2.3 percent) and more complications occurring within 3 months of hospital discharge (12.4 percent vs 5.4 percent), 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.