[Perioperative treatment for senile lumbar disease accompanied by internal disease].

OBJECTIVE

To investigate the surgical method and perioperative treatment for senile lumbar disease accompanied by internal disease.

METHODS

From June 2000 to December 2003, the complete neurological and physical examinations were performed on the patients before operation, as treatment of internal diseases could improve the patients' conditions. Lumbar operations were performed on 125 patients, among whom 23 had simple lumbar disc herniation, 13 had lumbar spine stenosis, 81 had lumbar disc herniation with lumbar spine stenosis, and 8 had spondylolisthesis. The JOA score was 11.6 +/- 2.5. There were 3 patients undergoing fenestration + discectomy, 16 undergoing semi-laminectomy + discectomy, 82 undergoing total-laminectomy + discectomy, 5 undergoing total-laminectomy+discectomy+pedicle fixation, 11 undergoing lamina decompression+nerve-root pathway decompression, and 8 undergoing pedicle screw fixation+bone graft and fusion in spondylolisthesis.

RESULTS

With an effective medical treatment, the internal disease produced little effect on the operation. Improved functions and bone fusions were observed after operation. According to the JOA standards, the average alleviation rate was 87.9%.

CONCLUSION

Early neurological examination and proper treatment of internal diseases are the keys to the successful operation on the senile patients with lumbar disease. Radiological data are important in avoidance of mistaken diagnosis.