Instrumented Posterolateral Spinal Arthrodesis as an Effective Treatment for Single Level Symptomatic Vacuum Lumbar Disc Degeneration in Elderly Patients

Background Data: Lumbar intervertebral disc vacuum phenomenon is an advanced form of spinal destabilizing degenerative changes. It is common in the elderly population and can cause refractory low back pain.Purpose: To evaluate the efficacy and safety of instrumented posterolateral fusion in treating symptomatic lumbar single level vacuum phenomenon in elderly population.Study Design: Retrospective descriptive clinical case series.Patients and Methods: Twenty-one patients (16 males & 5 females), aging more than 65 years, had all their files reviewed. They were operated by instrumented posterolateral fusion to treat chronic refractory low back pain due to single level intervertebral lumbar disc vacuum phenomenon. They underwent operation after failure of adequate 6 months conservative management. Age, gender, symptoms duration, spinal level affected, surgery duration, length of hospital stay, intra or post-operative complications, visual analogue scale VAS for pain, and Lenke’s graft fusion classification at 1, 3 & 6 months postoperatively were all recorded.Results: The results of this study showed the most affected level was L4/L5, mean age was 73±7 years, mean symptoms duration was 11 years, mean surgery duration was 137±29 minutes, and mean VAS for preoperative-postoperative pain improvement was 5.9±1.2. Good fusion (Lenke’s grades A & B) was reported in 81% of patients. No major intra or postoperative complications.Conclusion: Instrumented posterolateral fusion in elderly population patients with mono-segmental advanced disc degeneration may yield clinical outcome with low operative risk. (2017ESJ150)