Spinal fusion and pedicle screw instrumentation in the treatment of spondylolisthesis over the age of 60.

BACKGROUND: Spinal fusion or instrumentation for the treatment of spondylolisthesis in elderly people is still an issue of controversy. The purpose of this study was to assess the clinical results of laminectomy, posterolateral fusion, and pedicle screw instrumentation in patients over age 60. MATERIALS AND METHODS: From 1993 through 1994, 94 spondylolisthesis patients over age 60 underwent laminectomy, posterolateral fusion and pedicle screw instrumentation. All the patients had follow-up examinations 3 months, 6 months, 1 year and then annually after the operation. At each follow-up visit, the clinical results and complications were evaluated and a radiographic assessment was performed. The follow-up period ranged from 2 to 4 years. At the final follow-up visit, we administered a questionnaire designed for clinical evaluation. RESULTS: Seventy-five patients (80%) obtained improvement in back pain, 75 patients (80%) got improvement in leg pain, and 65 patients (69%) needed no medications. The average distance the patients were able to walk, at one time was 2.2 km. Sixty-seven patients (71%) could walk more than 500 m at a time. Seventy-four patients (79%) showed solid fusion, 20 patients inadequate fusion, and no psuedoarthrosis was found. Complications were rare. CONCLUSION: Laminectomy with spinal fusion and instrumentation is a good method for the treatment of spondylolisthesis in elderly people, and it can achieve a satisfactory clinical outcome.