The outcome of lumbar disc herniation surgery is worse in old adults than in young adults

Background and purpose — The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients. Patients and methods — With validated patient-reported out- come measures (PROMs) and using SweSpine (the national Swed- ish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000–2012. We included 1,250 elderly patients (> 65 years of age) and 12,840 young and middle-aged patients (aged 20–64). Results — Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and mid- dle-aged patients, they improved less by surgery, they experi- enced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfi ed with the outcome (with all differences being statistically signifi cant). Interpretation — Elderly patients appear to have a worse post- operative outcome after LDH surgery than young and middle- aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery.