Abstract
We investigated 22 patients older than 65 years who were diagnosed with lumbar disc herniation on surgical findings during a 14-year period. Most common preoperative symptoms were leg pain, low back pain and gait disturbance. Nine cases were unable to walk due to severe leg pain. Positive femoral nerve stretch test was found in 12 cases, positive straight leg raising test in 7 cases, sensory disturbance in 13 cases, and motor weakness in 9 cases (drop foot in 2 cases). Types of disc herniation included protrusion in 10 cases, extrusion in 9 cases, and sequestration in 3 cases. Follow up ranged from 1 month to 8 years (mean; 28 months). Seventy-seven % of patients had excellent or good results. There were no poor results and no one required additional surgery. Average recovery rate with JOA score (Hirabayashi) after surgery was 81.3% at final follow up. Clinical symptoms were markedly improved especially those involving leg pain and gait.
From these results, we concluded that lumbar disc herniation should be treated surgically even in the elderly, when conservative therapy is ineffective.
