Atabey Cem, Gocmen Selcuk, Simsek Hakan, Zorlu Emre, Demircan Mehmet Nusret, Colak Ahmet, Dinc Cem
GATA Haydarpasa Education Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2012;22(5):534-9. doi: 10.5137/1019-5149.JTN.5981-12.1.
The aim of this study is to evaluate results of surgery in Degenerative Spondylolisthesis (DS) patients over 70 years old.
This is a non-randomized retrospective analysis of the clinical outcome of 34 patients older than 70 years who underwent surgery. At the end of two-year follow-up period, preoperative and postoperative courses were assessed by Oswestry Disability Index (ODI) and Visual Analog Scales (VAS).
The mean age was 75 years (range 70-86 years). The mean duration of symptoms was 13.5 years (range 2-30 years). All patients underwent physiotherapy and also 15 (11 female, 4 male) patients used brace. L4-L5 was the most commonly affected level (n=26), Preoperative ODI and VAS scores were mean 71,63 (range 34-100) and 6,77 (range 2-9) (p < 0,05). Postoperative ODI and VAS scores were mean 22,73 (range 0-100) and 2,13 (range 0-10) (p < 0,05). Patients were asked if they had known the outcome, would they accept surgical treatment or not. 86.6% (n=26) of the patients answered the question positively.
A conventional decompressive laminectomy with foraminotomy and posterolateral fusion in situ with transpedicular instrumentation is necessary and reduces pain and recovers functional disability in elderly patients over 70 years old with DS.
本研究旨在评估70岁以上退行性腰椎滑脱（DS）患者的手术效果。
这是一项对34例70岁以上接受手术患者临床结局的非随机回顾性分析。在两年随访期结束时，采用Oswestry功能障碍指数（ODI）和视觉模拟评分法（VAS）评估术前和术后病程。
平均年龄为75岁（范围70 - 86岁）。症状平均持续时间为13.5年（范围2 - 30年）。所有患者均接受了物理治疗，15例（11例女性，4例男性）患者使用了支具。L4 - L5是最常受累节段（n = 26），术前ODI和VAS评分分别平均为71.63（范围34 - 100）和6.77（范围2 - 9）（p < 0.05）。术后ODI和VAS评分分别平均为22.73（范围0 - 100）和2.13（范围0 - 10）（p < 0.05）。询问患者如果他们知道结果，是否会接受手术治疗。86.6%（n = 26）的患者给出肯定回答。
对于超过70岁的DS老年患者，进行传统的减压性椎板切除术、椎间孔切开术以及经椎弓根器械原位后外侧融合术是必要的，可减轻疼痛并恢复功能障碍。
