Follow-up of Pedicle Screw Fixation for Lumbar Spinal Instability over 60 Years Old

ABSTRACT

OBJECTIVE: In accordance with the increasing number of elderly people in our society, the incidence of pedicle screw fixation which is a technically demanding procedure and requires a lengthy operation time has increased in the patients with lumbars instability over 60 years old. To ascertain the outcome and efficacy of the pedicle screw fixation in patients over 60 years old, we analyzed the surgical results including complications. PATIENTS AND METHOD: From May, 1994 to September, 1997, we assessed 30 patients over 60 years of age and 159 patients under the age of 60 with lumbar spinal instability who underwent surgery of pedicle screw fixation and compared with the results of surgery between two groups. RESULTS: For the elderly, the average operation time was 244 minutes and the transfusion amount was 3.3 pints. For younger patient the average operation time was 246 minutes and the transfusion amount was 3.2 pints. Four surgical complications occurred; two patients with voiding difficulty, one patient with heart problem, and a patient with DIC(Disseminated Intravascular Coagulation). However, all complications were controlled without further problems. The success rate in the elderly was 60%, which was lower than the success rate of 76% among younger patients. CONCLUSION: Considering the condition of the diseases in the elderly and the fact that the operations were performed without any major problems, these results are acceptable. Based on our analysis, it is our view that advanced age per se should not be regarded as a contraindication for pedicle screw fixation.