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I'm thinking about having surgery to relieve my back pain from spinal stenosis. Besides the usual risk of infection and blood clots from any surgery, is there any reason NOT to have this operation?

There has been some debate about the safety of this surgery in the older adult (especially over 85 years of age). You didn't list your age, but here's what we can tell you.

Many studies urge caution in choosing spinal surgery for older adults. The risk of complications and even death increase with each passing decade. For adults between 65 and 84, have a complication rate of almost 12 per cent.

That risk goes up even more if the person has three or more comorbidities. Comorbidities refers to the presence of other health problems. These can include heart or lung disease, thyroid dysfunction, and anemia or other blood disorders. The list is endless and most patients have at least one or two other health issues.

The biggest drawback in some patient's minds is the risk of discharge to a nursing home or extended care facility. The odds of going home directly from the hospital are low in this group. The effects of age and comorbidities can work against you.

But the good news is that more and more people who are discharged to some type of institution (other than home) are going home later. Rehab and home health care are making this possible (not to mention the determination of this age group to get home).

When making your decision about surgery, talk with your surgeon about all of the potential risk factors. Ask him or her to review with you your own unique risks and the chances that you could have an adverse outcome.

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