Spinal problems are frequent in people over 65 years of age. The pain can be localized only at the lumbar level or radiate to the legs as sciatica, preventing the patient from walking.
From the age of 65 onwards, aging significantly affects the spine. There are two very common lesions: osteoporotic vertebral fractures and spinal canal stenosis. In the case of women, the spine ages worse than in men. This is mainly due to osteoporosis, which means that the bone of women’s vertebrae is more fragile and breaks more easily, after exertion or even when coughing or sneezing hard.
There are certain vertebral fractures that may not cause symptoms and can be detected in a routine X-ray, although in most cases there is a sudden and intense pain in the dorsal or lumbar spine that sometimes prevents the patient from standing.
In spinal canal stenosis, the main symptom is neurogenic claudication, i.e., the patient starts walking and at a given moment has to stop because the legs do not respond or hurt, and may or may not have associated lumbar pain. When deciding on the treatment for these pathologies there are different options.
In vertebral fractures due to osteoporosis, it is usual to start with rest, analgesics and the use of a corset. In those cases in which after six weeks of conservative treatment the pain does not improve, a minimally invasive surgery can be performed under local anesthesia called vertebroplasty or kyphoplasty. This technique consists of percutaneously injecting a special acrylic cement for the bone into the vertebra.
It is performed with an incision of 3 millimeters and through a trocar, whose position is controlled by intraoperative radiology, the cement is injected. The patient goes home without pain the same day of surgery.
In the case of canal stenosis, in which the patient can hardly walk because of leg pain, drug treatments or infiltrations have a temporary effect, so the most effective and long-lasting treatment is surgery.
It is a disease that does not cure itself. It can remain stable or get worse, but not better. Therefore, it is absurd to delay surgery out of fear, since the older you get, the more associated diseases you tend to have.
If you want to get better, you must have surgery or resign yourself to never walking medium or long distances again. A preparatory assessment by the anesthesiologist is essential, due to the patient’s age.
This type of surgery is performed with minimally invasive techniques, which will allow the problem to be solved with the least aggressiveness, increasing safety and reducing complications and recovery time. With good coordination between surgeons and anesthesiologists, we routinely operate on patients over 80 years of age.
In the Spine Unit of the Polyclinic HM IMI Toledo interventions are performed jointly by orthopedic surgeons and neurosurgeons providing the best of both specialties.