Background: Acute disc prolapse in young adults has been studied extensively. However, little is known about acute disc prolapse in the elderly.
Objective: We aimed to define the features of acute disc prolapse in the elderly.
Design, setting and patients: Elderly (≥ 65 years) patients who had lumbar or thoracic discectomy for acute (< 3 months) disc prolapse in our unit between July 2004 and March 2010 were identified. For comparison, we used a 'young' (25-45 years) patient cohort with acute thoracic or lumbar disc prolapse. Data collected included age, symptom onset, preoperative signs and spinal level.
Results: During the study period, 390 patients had discectomy, of which 59.7% were 'young' and 7.4% 'elderly'. The young and elderly patients had significantly different distributions of prolapsed disc levels. In the young, 97% of all disc protrusions were at L4/5 or L5/S1, but < 50% were at these levels in the elderly. In the elderly, about 10% of disc protrusions were thoracic.
Conclusions: Acute disc prolapse is rare in the elderly and primarily affects the upper lumbar and lower thoracic spine.