Affecting factors and strategies of surgical treatment for elder people with lumbar disc herniation

Objective To investigate the surgical outcomes and complications of lumbar disc herniation in elderly patients. Methods A retrospective collection of 460 elderly patients with lumbar disc herniation from January 2010 to January 2017 was performed, including 274 males (59.57%) and 186 females (40.43%), aged (77±17) years old, of which 371 (80.65%) patients with single gap were treated with laminectomy and nucleus pulposus removal, and 89 patients (19.35%) with double interstitial disc herniation were treated with posterior interbody fusion rod system. All patients were evaluated by the Japanese Orthopaedic Association JOA score, and complications were followed up. Results All 460 patients were followed up for 12 months, the followed up ratio for 100%. The JOA score was excellent in 313 cases (68.04%), good in 112 cases (23.34%), middle case in 32 cases (6.96%), poor in 3 cases (0.65%), excellent and good rate was 92.39%, and complication rate was 7.83%. The average bleeding volume of all patients during and after surgery was (200±35) ml, and the drainage volume was (150±20) ml. Conclusions Older patients often have systemic diseases. The operation is difficult, and many factors affecting the cure. The preoperative diagnosis, preoperative preparation, careful operation during operation, close observation of the patient's condition after surgery, active prevention and timely manage post-complication can effectively improve the curative effect and reduce the occurrence of complications. Key words: Aged; Lumbar disc herniation; Surgical procedures operative; Complications