Lumbar disc herniation in the elderly

Abstract

A retrospective study of lumbar disc herniation in the elderly was performed. Fifty-nine cases (37 males, 22 females) of lumbar disc herniation in patients over 60 years old operated on from 1988 to 2001 were evaluated. Clinical manifestation, physical condition, image findings and surgical records were examined.While younger patients showed more restriction in lumbar flexion than the elderly, elderly patients showed more restriction in lumbar extension. Most elderly patients showed the positive Kemp phenomenon and difficulty in walking due to leg pain. A positive SLR-test was less common as age advanced and the raising angle increased with age. Regarding with the position of herniation in the axial view, lateral types (foraminal and extra-foraminal) were more frequent. In the elderly, ADL quality was worse than in younger people. It is assumed that such characteristics are the result from relative stenotic conditions of the spinal canal and degenerative changes in the nerve root due to the aging.