Elderly male has backache. Man leans on wooden fence. Problems with spine. Pain from herniated disk.
65 and over patient group experiences greater improvement in low back pain after an operation, study shows. Photo: Thinkstock

Age no barrier for herniated disc surgery

People 65 and older benefit just as much from an operation for a slipped disc in the lower back as do younger patients.

Back surgery:Age does not need to be the decisive factor in herniated disc surgery, according to a study conducted by NTNU medical student Mattis A. Madsbu and colleagues in the Department of Neurosurgery at St. Olav’s Hospital in Trondheim. Madsbu’s supervisor was NTNU consultant neurosurgeon Sasha Gulati.

“This study shows that it is fully possible to do good surgical research on elderly patients,” says Madsbu.

Lumbar (lower back) spine surgery is a common intervention, with almost 2,000 such procedures being carried out in Norway annually. Study data on surgical outcomes among elderly patients have been limited. Until now.

The recent study has been published in the prestigious JAMA Surgery journal.

More than 5500 patients

If you have a slipped disc, it means that one of the discs that serves as a cushion between each vertebra has been damaged. Slipped discs in the lower back are a common cause of sciatica. This condition can cause severe pain in the back and down the leg and foot. At worst, disc herniation can lead to paralysis.

If you have a slipped disc, it means that one of the discs that act as cushions between each vertebra has been damaged. Illustration: Thinkstock

If you have a slipped disc, it means that one of the discs that act as cushions between each vertebra has been damaged. Illustration: Thinkstock

Usually non-surgical treatment, such as exercise, heat treatment and painkillers, are recommended for patients without serious loss of motion, but this is not always enough.

Surgical treatment is usually offered to patients who have endured considerable pain for a long time despite a period with other treatment therapies.

Researchers at NTNU and St. Olav compared patient-reported treatment outcomes following lumbar spine surgery for 381 patients over 65 years and 5195 younger patients. The figures were taken from the Norwegian quality register for spinal surgery, a national registry for quality control and research.

Minor complications

The study also shows that the over-65 group of patients experiences greater improvement in their low back pain.

Compared with younger patients, older patients experienced more non-serious surgical complications (4.2 percent versus 2.3 percent) and they had somewhat longer hospital stays (1.8 versus 2.7 days).

Even so, this did not affect the treatment outcomes since the complications were less serious, according to Madsbu.

The authors conclude that age alone should not count against surgery.

Reference: Surgery for Herniated Lumbar Disk in Individuals 65 Years of Age or Older. A multicenter observational study. Mattis A. Madsbu, Tore K. Solberg, Øyvind Salvesen.