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Master Thesis

Surgical management of lumbar spinal stenosis in patients over 80: is there an increased risk?

Abstract : Background: The management of LSS is the first cause of spinal surgery for the elderly and will increase with the aging population. The surgery improves quality of life but involves operative risks. The aim of this study was to evaluate if the rate of postoperative complications was higher in elderly patients. Methods: We conducted a retrospective study that included all LSS procedures between 2012 and 2020 at the University Hospital of Caen. We compared patients aged over 80 years to all others. The primary endpoint was the occurrence of a severe complication (SC) within 30 days. Minor complications were the secondary endpoint. Comorbidities, history of lumbar spine surgery and surgical characteristics were recorded. Results: 996 patients undergoing surgery for degenerative LSS were identified. Patients over 80 years of age were affected by additional comorbidities: hypertension, heart diseases and higher age adjusted CCI and ASA scores and use of anticoagulants. Knee-chest position was preferred for the younger patients while older patients had more extensive surgery and more incidental durotomies. The rate of severe complications was 5.2% in the cohort. Age over 80 years did not appear to be a significant risk factor for SC, but the rate of minor complications was impacted. Multivariate analysis revealed that heart diseases, history of laminectomy, age adjusted CCI score, ASA grade and durotomies were risk factors for SC. Conclusion: Surgical management for LSS is not associated to a higher rate of SC for patients over the age of 80. Preoperative risk factors should be investigated to warn out the patient aged of the increased risk of complications.
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https://dumas.ccsd.cnrs.fr/dumas-03561769
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Submitted on : Tuesday, February 8, 2022 - 2:39:23 PM
Last modification on : Saturday, April 2, 2022 - 3:38:36 AM
Long-term archiving on: : Monday, May 9, 2022 - 7:49:08 PM

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  • HAL Id : dumas-03561769, version 1

Citation

Frédérick Rault. Surgical management of lumbar spinal stenosis in patients over 80: is there an increased risk?. Human health and pathology. 2021. ⟨dumas-03561769⟩

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