M. Benoist, Natural History of the Aging Spine', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.12, pp.86-89, 2003.

D. Butler, Discs Degenerate before Facets, Spine, vol.15, pp.111-124, 1990.

, Compensatory Mechanisms Contributing to Keep the Sagittal Balance of the Spine, European Spine Journal, vol.22, issue.6, pp.834-875, 2013.

D. Allbrook, Movements of the Lumbar Spinal Column, The Journal of Bone and Joint Surgery. British, vol.2, pp.339-384, 1957.

, Determinants of the Progression in Lumbar Degeneration: A 5-Year Follow-up Study of Adult Male Monozygotic Twins', Spine, vol.31, pp.671-78, 2006.

J. P. Thompson and . Others, Preliminary Evaluation of a Scheme for Grading the Gross Morphology of the Human Intervertebral Disc, Spine, vol.15, pp.411-426, 1990.

W. H. Kirkaldy-willis and H. F. Farfan, Instability of the Lumbar Spine, Clinical Orthopaedics and Related Research, vol.165, pp.110-133, 1982.

R. Noren and . Others, The Role of Facet Joint Tropism and Facet Angle in Disc Degeneration, Spine, vol.16, issue.5, pp.530-562, 1991.

C. W. , Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration', Spine, vol.26, pp.1873-78, 2001.

M. , Degenerative Disk Disease: Assessment of Changes in Vertebral Body Marrow with MR Imaging, Radiology, 166.1 Pt, vol.1, pp.193-99, 1988.

W. Frobin and . Others, Precision Measurement of Disc Height, Vertebral Height and Sagittal Plane Displacement from Lateral Radiographic Views of the Lumbar Spine, Clinical Biomechanics, vol.12, issue.1, pp.1-63, 1997.

B. Vernon-roberts and C. J. Pirie, Degenerative Changes in the Intervertebral Discs of the Lumbar Spine and Their Sequelae', Rheumatology and Rehabilitation, vol.16, pp.13-21, 1977.

J. H-f-farfan and . Sullivan, The Relation of Facet Orientation to Intervertebral Disc Failure, Canadian Journal of Surgery. Journal Canadien de Chirurgie, vol.10, issue.2, pp.179-85, 1967.

R. Noren and . Others, The Role of Facet Joint Tropism and Facet Angle in Disc Degeneration, Spine, vol.16, issue.5, pp.530-562, 1991.

A. Fujiwara and . Others, The Relationship between Disc Degeneration, Facet Joint Osteoarthritis, and Stability of the Degenerative Lumbar Spine, Journal of Spinal Disorders, vol.13, pp.444-50, 2000.

J. H-f-farfan and . Sullivan, The Relation of Facet Orientation to Intervertebral Disc Failure, Canadian Journal of Surgery. Journal Canadien de Chirurgie, vol.10, issue.2, pp.179-85, 1967.

A. Fujiwara and . Others, The Relationship between Disc Degeneration, Facet Joint Osteoarthritis, and Stability of the Degenerative Lumbar Spine, Journal of Spinal Disorders, vol.13, pp.444-50, 2000.

M. Sato, , vol.65, pp.1078-90, 1991.

. S-d-boden and . Others, Orientation of the Lumbar Facet Joints: Association with Degenerative Disc Disease, vol.78, pp.403-414, 1996.

T. W. Love, A. B. Fagan, and R. D. Fraser, Degenerative Spondylolisthesis. Developmental or Acquired?, vol.81, pp.670-74, 1999.

, The Role of Lumbar Lordosis, Vertebral End-Plate Inclination, Disc Height, and Facet Orientation in Degenerative Spondylolisthesis, Journal of Spinal Disorders, vol.12, issue.1, pp.68-73, 1999.

H. Hadar, N. Gadoth, and M. Heifetz, Fatty Replacement of Lower Paraspinal Muscles: Normal and Neuromuscular Disorders, AJR. American Journal of Roentgenology, vol.141, issue.5, pp.895-98, 1983.

W. H. Kirkaldy-willis and H. F. Farfan, Instability of the Lumbar Spine, Clinical Orthopaedics and Related Research, vol.165, pp.110-133, 1982.

A. F. Ian, J. C. Stokes, and . Iatridis, Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload versus Immobilization', Spine, vol.29, pp.2724-2756, 2004.

D. M. Spengler, Degenerative Stenosis of the Lumbar Spine, The Journal of Bone and Joint Surgery, vol.69, issue.2, pp.305-313, 1987.

D. E. Gelb and . Others, An Analysis of Sagittal Spinal Alignment in 100 Asymptomatic Middle and Older Aged Volunteers', Spine, vol.20, pp.1351-58, 1995.

P. Mangione and J. Sénégas, , vol.83, pp.22-32, 1997.

P. Guigui and N. Levassor, Physiological value of pelvic and spinal parameters of sagital balance: analysis of 250 healthy volunteers, vol.89, pp.496-506, 2003.

T. Amundsen and . Others, Lumbar Spinal Stenosis. Clinical and Radiologic Features', Spine, vol.20, pp.1178-86, 1995.

J. , Clinical Correlates of Patient Satisfaction after Laminectomy for Degenerative Lumbar Spinal Stenosis', Spine, vol.20, pp.1155-60, 1995.

J. A. Turner and . Others, Attempted Meta-Analysis of the Literature, Spine, vol.17, pp.1-8, 1992.

P. Guigui and M. Benoist, Motor Deficit in Lumbar Spinal Stenosis: A Retrospective Study of a Series of 50 Patients, Journal of Spinal Disorders, vol.11, issue.4, pp.283-88, 1998.

C. Bombardier, Outcome Assessments in the Evaluation of Treatment of Spinal Disorders: Summary and General Recommendations', Spine, vol.25, pp.3100-3103, 2000.

O. Niggemeyer, J. M. Strauss, and K. P. Schulitz, Comparison of Surgical Procedures for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis of the Literature from 1975 to 1995', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.6, pp.423-452, 1997.

J. A. Turner and . Others, Attempted Meta-Analysis of the Literature, Spine, vol.17, pp.1-8, 1992.

G. Stucki and . Others, Measurement Properties of a Self-Administered Outcome Measure in Lumbar Spinal Stenosis', Spine, vol.21, pp.796-803, 1996.

L. Kalichman and . Others, Spinal Stenosis Prevalence and Association with Symptoms: The Framingham Study, The Spine Journal: Official Journal of the North American Spine Society, vol.9, issue.7, pp.545-50, 2009.

P. D. De-villiers and E. L. Booysen, Clinical Orthopaedics and Related Research, vol.115, pp.140-184, 1976.

J. , The Impact of Spinal Problems on the Health Status of Patients: Have We Underestimated the Effect?', Spine, vol.25, pp.1509-1523, 2000.

M. E. , A New Method of Classifying Prognostic Comorbidity in Longitudinal Studies: Development and Validation, Journal of Chronic Diseases, vol.40, pp.373-83, 1987.

M. Charlson and . Others, Validation of a Combined Comorbidity Index, Journal of Clinical Epidemiology, vol.47, pp.1245-51, 1994.

J. E. Morley and . Others, Frailty Consensus: A Call to Action, Journal of the American Medical Directors Association, vol.14, issue.6, pp.392-97, 2013.

L. P. , Frailty in Older Adults: Evidence for a Phenotype, Biological Sciences and Medical Sciences, vol.56, issue.3, pp.146-156, 2001.

K. Rockwood and . Others, A Global Clinical Measure of Fitness and Frailty in Elderly People, CMAJ: Canadian Medical Association Journal = Journal de l'Association Medicale Canadienne, vol.173, pp.489-95, 2005.

N. M. De, Outcome Instruments to Measure Frailty: A Systematic Review, Ageing Research Reviews, vol.10, issue.1, pp.104-118, 2011.

R. Hébert, L'évaluation de l'autonomie Fonctionnelle Des Personnes, Âgées', Canadian Family Physician, vol.28, pp.754-62, 1982.

J. , Clément and others, '[Development and contribution to the validation of a brief French version of the Yesavage Geriatric Depression Scale, L'Encephale, vol.23, issue.2, pp.91-99, 1997.

M. F. Folstein, S. E. Folstein, and P. R. Mchugh, A Practical Method for Grading the Cognitive State of Patients for the Clinician', Journal of Psychiatric Research, vol.12, issue.3, pp.189-98, 1975.

A. T. Beekman, J. R. Copeland, and M. J. Prince, Review of Community Prevalence of Depression in Later Life, The British Journal of Psychiatry: The Journal of Mental Science, vol.174, pp.307-318, 1999.

G. Abellan-van-kan, Y. Rolland, and S. Andrieu, Gait Speed at Usual Pace as a Predictor of Adverse Outcomes in Community-Dwelling Older People an International Academy on Nutrition and Aging (IANA) Task Force, The Journal of Nutrition, vol.13, pp.881-89, 2009.

G. Abellan-van-kan, Y. Rolland, H. Bergman, and I. A. The, A Task Force on Frailty Assessment of Older People in Clinical Practice, The Journal of Nutrition, vol.12, issue.1, pp.29-37, 2008.

J. , Lower Extremity Function and Subsequent Disability: Consistency across Studies, Predictive Models, and Value of Gait Speed Alone Compared with the Short Physical Performance Battery, Biological Sciences and Medical Sciences, vol.55, pp.221-231, 2000.

D. P. Leong and . Others, Prognostic Value of Grip Strength: Findings from the Prospective Urban Rural Epidemiology (PURE) Study, Lancet, pp.266-73, 2015.

J. Hogrel, Grip Strength Measured by High Precision Dynamometry in Healthy Subjects from 5 to 80 Years, BMC Musculoskeletal Disorders, vol.16, p.139, 2015.

E. Savino and . Others, Handgrip Strength Predicts Persistent Walking Recovery after Hip Fracture Surgery, The American Journal of Medicine, vol.126, pp.1068-1075, 2013.

M. Louis, Report of a Simplified Frailty Score Predictive of Short-Term Postoperative Morbidity and Mortality, Journal of the American College of Surgeons, vol.220, issue.5, pp.904-911, 2015.

P. Oliver, . Gautschi, and . Others, Influence of Age on Pain Intensity, Functional Impairment and Health-Related Quality of Life before and after Surgery for Lumbar Degenerative Disc Disease, Clinical Neurology and Neurosurgery, vol.150, pp.33-39, 2016.

, Predictors of Improvement in Quality of Life and Pain Relief in Lumbar Spinal Stenosis Relative to Patient Age: A Study Based on the Spine Tango Registry', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.26, pp.462-72, 2017.

J. Clinton, A Cost-Utility Analysis of Lumbar Decompression With and Without Fusion for Degenerative Spine Disease in the Elderly, vol.77, pp.116-124, 2015.

M. Thomas, . O'lynnger, and . Others, Trends for Spine Surgery for the Elderly: Implications for Access to Healthcare in North America, vol.77, pp.136-141, 2015.

, Is Eighty the New Sixty? Outcomes and Complications after Lumbar Decompression Surgery in Elderly Patients over 80 Years of Age, Julia Gerhardt and others, vol.112, pp.555-60, 2018.

, Is It Safe to Perform Lumbar Spine Surgery on Patients over Eighty Five?, International Orthopaedics, vol.41, issue.10, pp.2091-96, 2017.

F. Costa and . Others, Instrumented Fusion Surgery in Elderly Patients (over 75 Years Old): Clinical and Radiological Results in a Series of 53 Patients', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.22, pp.910-913, 2013.

H. Nils, Clinical Outcome in Lumbar Decompression Surgery for Spinal Canal Stenosis in the Aged Population: A Prospective Swiss Multicenter Cohort Study, Spine, vol.40, issue.6, pp.415-437, 2015.

S. Asgeir, . Jakola, and . Others, Clinical Outcomes and Safety Assessment in Elderly Patients Undergoing Decompressive Laminectomy for Lumbar Spinal Stenosis: A Prospective Study, BMC Surgery, vol.10, p.34, 2010.

D. Michael, Decompression Alone versus Decompression with Limited Fusion for Treatment of Degenerative Lumbar Scoliosis in the Elderly Patient', Evidence-Based Spine-Care Journal, vol.3, pp.27-32, 2012.

A. Jeffrey, Effectiveness of Surgery for Lumbar Stenosis and Degenerative Spondylolisthesis in the Octogenarian Population: Analysis of the Spine Patient Outcomes Research Trial (SPORT) Data, The Journal of Bone and Joint Surgery, vol.97, issue.3, pp.177-85, 2015.

, Effects of Minimally Invasive Decompression Surgery on Quality of Life in Older Patients with Spinal Stenosis, Clinical Neurology and Neurosurgery, vol.139, pp.86-90, 2015.

J. Matthew, Lumbar Surgery in the Elderly Provides Significant Health Benefit in the US Health Care System: Patient-Reported Outcomes in 4370 Patients From the N2QOD Registry, Neurosurgery, vol.77, issue.4, pp.125-135, 2015.

, Proactive Care of Older People Undergoing Surgery ('POPS'): Designing, Embedding, Evaluating and Funding a Comprehensive Geriatric Assessment Service for Older Elective Surgical Patients, Age and Ageing, vol.36, issue.2, pp.190-96, 2007.

L. Kalichman and . Others, Spinal Stenosis Prevalence and Association with Symptoms: The Framingham Study, The Spine Journal: Official Journal of the North American Spine Society, vol.9, issue.7, pp.545-50, 2009.

D. Dindo, N. Demartines, and P. Clavien, Classification of Surgical Complications: A New Proposal with Evaluation in a Cohort of 6336 Patients and Results of a Survey, Annals of Surgery, vol.240, issue.2, pp.205-218, 2004.

, Is Eighty the New Sixty? Outcomes and Complications after Lumbar Decompression Surgery in Elderly Patients over 80 Years of Age, Julia Gerhardt and others, vol.112, pp.555-60, 2018.

, Is It Safe to Perform Lumbar Spine Surgery on Patients over Eighty Five?, International Orthopaedics, vol.41, issue.10, pp.2091-96, 2017.

P. Oliver, . Gautschi, and . Others, Influence of Age on Pain Intensity, Functional Impairment and Health-Related Quality of Life before and after Surgery for Lumbar Degenerative Disc Disease, Clinical Neurology and Neurosurgery, vol.150, pp.33-39, 2016.

, Predictors of Improvement in Quality of Life and Pain Relief in Lumbar Spinal Stenosis Relative to Patient Age: A Study Based on the Spine Tango Registry', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.26, pp.462-72, 2017.

A. Jeffrey, Effectiveness of Surgery for Lumbar Stenosis and Degenerative Spondylolisthesis in the Octogenarian Population: Analysis of the Spine Patient Outcomes Research Trial (SPORT) Data, The Journal of Bone and Joint Surgery, vol.97, issue.3, pp.177-85, 2015.

, The Influence of Age on the Peri-and Postoperative Clinical Course in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion Techniques of the Lumbar Spine, Clinical Neurology and Neurosurgery, vol.182, pp.25-31, 2019.

J. Nikhil and N. Others, Elderly Patients Achieving Clinical and Radiological Outcomes Comparable with Those of Younger Patients Following Minimally Invasive Transforaminal Lumbar Interbody Fusion, Asian Spine Journal, vol.11, issue.2, pp.230-272, 2017.

, Effects of Minimally Invasive Decompression Surgery on Quality of Life in Older Patients with Spinal Stenosis, Clinical Neurology and Neurosurgery, vol.139, pp.86-90, 2015.

C. Banse and . Others, Impact of Assessment of Bone Status before Corrective Surgery of Lumbar Spine in Patients over 50 Years Old, Open Access Rheumatology: Research and Reviews, vol.11, pp.111-126, 2019.
URL : https://hal.archives-ouvertes.fr/hal-02430632

, Radiographic and Functional Outcomes of Bisphosphonate Use in Lumbar Fusion: A Systematic Review and Meta-Analysis of Comparative Studies', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.29, pp.272-81, 2020.

C. L. Goldstein, D. S. Brodke, and T. J. Choma, Surgical Management of Spinal Conditions in the Elderly Osteoporotic Spine, vol.77, pp.98-107, 2015.

J. Clinton, A Cost-Utility Analysis of Lumbar Decompression With and Without Fusion for Degenerative Spine Disease in the Elderly, vol.77, pp.116-124, 2015.

M. Thomas, . O'lynnger, and . Others, Trends for Spine Surgery for the Elderly: Implications for Access to Healthcare in North America, vol.77, pp.136-141, 2015.

N. Thomas, . Robinson, and . Others, Redefining Geriatric Preoperative Assessment Using Frailty, Disability and Co-Morbidity', Annals of Surgery, vol.250, issue.3, pp.449-55, 2009.

, International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients with Cancer, Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, vol.32, pp.2595-2603, 2014.

K. Kobayashi and . Others, Epidemiological Trends in Spine Surgery over 10 Years in a Multicenter Database, Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.27, pp.1698-1703, 2018.

P. Oliver, . Gautschi, and . Others, Influence of Age on Pain Intensity, Functional Impairment and Health-Related Quality of Life before and after Surgery for Lumbar Degenerative Disc Disease, Clinical Neurology and Neurosurgery, vol.150, pp.33-39, 2016.

, Predictors of Improvement in Quality of Life and Pain Relief in Lumbar Spinal Stenosis Relative to Patient Age: A Study Based on the Spine Tango Registry', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.26, pp.462-72, 2017.

A. Jeffrey, Effectiveness of Surgery for Lumbar Stenosis and Degenerative Spondylolisthesis in the Octogenarian Population: Analysis of the Spine Patient Outcomes Research Trial (SPORT) Data, The Journal of Bone and Joint Surgery, vol.97, issue.3, pp.177-85, 2015.

G. Abellan-van-kan, Y. Rolland, and S. Andrieu, Gait Speed at Usual Pace as a Predictor of Adverse Outcomes in Community-Dwelling Older People an International Academy on Nutrition and Aging (IANA) Task Force, The Journal of Nutrition, vol.13, pp.881-89, 2009.

, Complications of Spinal Surgery for Elderly Patients with Lumbar Spinal Stenosis in a Super-Aging Country: An Analysis of 8033 Patients, Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association, vol.22, issue.1, pp.10-15, 2017.

G. Li and . Others, Effects of Age and Comorbidities on Complication Rates and Adverse Outcomes after Lumbar Laminectomy in Elderly Patients, Spine, vol.33, pp.1250-55, 2008.

K. Tadokoro and . Others, The Prognosis of Conservative Treatments for Lumbar Spinal Stenosis: Analysis of Patients over 70 Years of Age', Spine, vol.30, pp.2458-63, 2005.

, Outcome and Complications in Surgical Treatment of Lumbar Stenosis or Spondylolisthesis in Geriatric Patients, Yonsei Medical Journal, vol.56, issue.5, pp.1199-1205, 2015.

F. Mohammed, . Shamji, and . Others, Management of Degenerative Lumbar Spinal Stenosis in the Elderly, vol.77, pp.68-74, 2015.

D. Pérez, -. Prieto, and . Others, Should Age Be a Contraindication for Degenerative Lumbar Surgery?', European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol.23, pp.1007-1019, 2014.

H. Nils, Clinical Outcome in Lumbar Decompression Surgery for Spinal Canal Stenosis in the Aged Population: A Prospective Swiss Multicenter Cohort Study, Spine, vol.40, issue.6, pp.415-437, 2015.

, Effects of Minimally Invasive Decompression Surgery on Quality of Life in Older Patients with Spinal Stenosis, Clinical Neurology and Neurosurgery, vol.139, pp.86-90, 2015.

, Is It Safe to Perform Lumbar Spine Surgery on Patients over Eighty Five?, International Orthopaedics, vol.41, issue.10, pp.2091-96, 2017.

, Is Eighty the New Sixty? Outcomes and Complications after Lumbar Decompression Surgery in Elderly Patients over 80 Years of Age, Julia Gerhardt and others, vol.112, pp.555-60, 2018.

J. Clinton, A Cost-Utility Analysis of Lumbar Decompression With and Without Fusion for Degenerative Spine Disease in the Elderly, vol.77, pp.116-124, 2015.

M. Thomas, . O'lynnger, and . Others, S136-141 RESUME Introduction Les phénomènes de dégénérescence du rachis lombaire aboutissent à un rétrécissement canalaire identifié sous le terme de sténose lombaire dégénérative dont le retentissement clinique est à l'origine d'un handicap fonctionnel, vol.77, 2015.

, L'évaluation gériatrique standardisée est une approche multidisciplinaire globale développée pour évaluer les aspects médicaux, fonctionnels et psychosociaux des sujets âgés et ainsi proposer un plan personnalisé de soins

, L'objectif principal de ce travail est de réaliser l'analyse descriptive chirurgicale et gériatrique d'une population de patients de plus de 75 ans pour lesquels une chirurgie de sténose lombaire est envisagée

, Matériels et Méthodes Il s'agit d'une étude observationnelle rétrospective s'étendant de Novembre, 2016.

, Une évaluation préthérapeutique par l'équipe de gériatrie était systématiquement réalisée dans les 3 mois précédents la chirurgie. Les données recueillies comportaient : les paramètres cliniques et radiologiques chirurgicaux, les comorbidités du patient (score de Charlson), les paramètres cliniques gériatriques (autonomie, dépendance, dénutrition, polymédication, cognition, dépression, troubles de la marche et de l'équilibre, fragilité, Ont été inclus les patients de plus de 75 ans présentant une sténose lombaire dégénérative ayant été pris en charge par l'équipe de l'institut régional du rachis du CHU de Rouen

, Résultats 92 patients ont bénéficié d'une évaluation de leur fragilité. 12 patients n'ont pas été opérés en raison de leur amélioration clinique ou d'une contre-indication médicale ou perdus de vue. La qualité de vie était globalement altérée que ce soit pour l'ODI ou le SF12. Le périmètre de marche était très diminué tout comme la vitesse de marche. Le nombre de comorbidités était faible

, 56/6 et un score IADL moyen de 6.13/8. 25% des patients présentaient des troubles cognitifs caractérisés. Le nombre d'étages libérés moyen était de 2.11. La majorité était arthrodèsée sur 2 niveaux ou moins : 72.5% dont 22.5% ayant eu un recalibrage seul. 67% des patients sortaient en convalescence. La durée moyenne de séjour en hospitalisation était de 10.5 jours. 63% des patients ont présenté au moins une complication, L'autonomie était préservée avec un score ADL moyen à 5

, Les facteurs prédictifs de sortie en SSR sont : le nombre de niveaux fusionnés élevé, un ODI élevé et une vitesse de marche faible. La vitesse de marche, le périmètre de marche ainsi que les complications ont été retrouvé comme facteurs prédictifs de séjour prolongé

, Conclusion La chirurgie des sténoses lombaires des sujets âgés a une place dans l'arsenal thérapeutique

, Elle est néanmoins associée à une morbidité non-négligeable mais qui apparaît plus finement prévisible si un bilan préopératoire adéquat est réalisé. En plus des évaluations fonctionnelles chirurgicales, le dépistage de fragilité gériatrique fournit des éléments prédictifs performants qu'il faut tenter d