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The Prognosis of Conservative Treatments for Lumbar Spinal Stenosis: Analysis of Patients Over 70 Years of Age

Tadokoro, Kou, MD*; Miyamoto, Hiroshi, MD*; Sumi, Masatoshi, MD*; Shimomura, Takatoshi, MD

doi: 10.1097/01.brs.0000184692.71897.a2
Health Services Research
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Study Design. A prospective study.

Objectives. To identify outcomes of aged patients with lumbar spinal stenosis (LSS) treated conservatively and to examine factors that control the prognosis.

Summary and Background Data. There have been no reports evaluating the outcomes of conservative treatments for elderly LSS patients.

Methods. A total of 89 patients, 70 years of age and older, who underwent in-hospital conservative treatment were included. The Japanese Orthopedic Association’s score (JOA score) and the disturbance level of activities of daily living (ADL) were used for evaluation. Nerve involvement was classified into radicular, cauda equina, and mixed type. Myelographic findings were classified into central defect with or without block and root defect. Associations between disturbance level of ADL, nerve involvement, and myelographic classifications were investigated.

Results. The mean JOA score increased from 11.1 points at admission to 15.9 points at discharge, with 14.3 points maintained at the follow-up; 48.8% of radicular type showed no obstacle in ADL at the follow-up compared with 33.3% of the other types; 13.3% of central defect with block showed no obstacle in ADL compared with 47.8% of the other types with significant difference.

Conclusion. The prognosis of conservative treatment for aged LSS was relatively good. Radicular type may be a candidate for conservative treatment. However, patients with complete block in the myelogram may not respond favorably to conservative treatment.

The outcomes of patients older than 70 years of age with lumbar spinal stenosis treated conservatively were identified, and factors that control the prognosis were examined. Radicular type in nerve involvement was found to be a good candidate for conservative treatment; in contrast, complete block type in the myelography may not respond favorably.

From the *Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan; and the †Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Acknowledgment date: December 21, 2004. First revision date: July 1, 2005. Acceptance date: August 2, 2005.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Kou Tadokoro, MD, Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center, Nishiochiai 3-1-1, Suma-ku, Kobe, Japan; E-mail: ko-taddy@sc5.so-net.ne.jp

© 2005 Lippincott Williams & Wilkins, Inc.