OBJECTIVE: To observe in detail the relationship between preoperative cardiovascular indices and surgical safety and complications in elderly patients with degenerative lumbar spinal stenosis. METHODS: From January 2002 to January 2008, 580 patients with lumbar spinal stenosis were hospitalized for spinal decompression, pedicle screw internal fixation, and intertransverse or intervertebral bone grafting, aged 65-83 years, with an average age of 67.2 years; 312 were men and 268 were women. Many patients were combined with one or more of the medical comorbidities. Among them, there were 182 cases of combined hypertension, 16 cases of coronary artery disease, 6 cases of coronary artery disease who had been bypassed, 12 cases of coronary artery disease after stent surgery, 5 cases of old infarction, 7 cases of atrioventricular block, and 5 cases of supraventricular and premature ventricular beats. The relationship between intraoperative bleeding, postoperative cerebrovascular accident, arrhythmia, coronary attack, and infarction complications and the level of preoperative hypertension, control stability, history of coronary heart disease, post-bypass, post-stenting, and arrhythmia was observed. Results: (1) 169 of 182 patients with combined hypertension had stable preoperative blood pressure control in the normal range or 150 mmHg systolic and 90 mmHg diastolic for at least 1 week. echocardiographic ejection fraction was not less than 60. intraoperative blood pressure control was not less than 110 mmHg systolic. no significant cardiovascular system complications intraoperatively or postoperatively. 13 patients with unstable control had blood pressure fluctuated between 180 mmHg and 140 mmHg. The blood pressure was controlled at 140 mmHg before surgery and reached 180 mmHg before the operation, but it was reduced to 140 mmHg after sedation. 800 ml of blood was lost intraoperatively and 800 ml of whole blood was transfused, but the blood pressure was controlled at 90-100 mmHg for 10 minutes during intraoperative anesthesia. 2 cases had postoperative angina attacks, which improved with medication. (2) Coronary artery disease (2) 16 cases of coronary artery disease with infrequent episodes, preoperative myocardial nuclei suggesting mild myocardial ischemia, and echocardial ejection fraction of 60 or more. Intraoperative blood pressure was controlled above 110 mmHg, and 2 cases had a history of chest tightness and precordial pain after surgery, with no serious complications after treatment. , (3) 6 patients with coronary artery disease bypass, no angina attack, normal preoperative myocardial nuclei, echocardial ejection fraction above 60, and intraoperative blood pressure control above 110 mmHg. The anticoagulants were stopped 1 week before surgery and the coagulation image was normal allowing the surgery. 1 elderly patient aged 75 years had an epidural hematoma after surgery, twice on the operating table to clean the hematoma to stop the bleeding and intraoperative platelet transfusion to stop the bleeding. The patient eventually recovered. (4) There were 12 cases after coronary stenting, and the preoperative management was the same as that of coronary bypass patients. No 1 case had serious complications after the operation. (5) Three cases of old infarction had preoperative ejection fraction of 60 or more and no serious postoperative complications. two cases had preoperative ejection fraction of 55 and developed short-term heart failure after surgery, which improved after correction. (6) Four patients with atrioventricular block of less than 2 degrees had a quiet heart rate of 60 beats or more, and three patients with atrioventricular block of more than 2 degrees had a heart rate of less than 60 beats, and were routinely fitted with permanent or temporary pacemakers without serious postoperative complications. (7) Three cases of supraventricular tachycardia were controlled with medication without postoperative complications, and eight cases of nonfrequent premature ventricular beats were controlled with medication without postoperative complications. CONCLUSION: Elderly patients with degenerative lumbar spinal stenosis for which conservative treatment is ineffective can be considered for surgical treatment after a strict preoperative physical condition assessment without contraindications to surgery. Concomitant cardiovascular disease, including unstable hypertension control, low intraoperative blood pressure control, and perioperative complications with an ejection fraction below 55 are more likely. over 70 years of age with anticoagulant application discontinued for 1 week still have high bleeding and the possibility of postoperative epidural hematoma. Infrequent episodes of coronary artery disease can reduce the occurrence of complications with well-controlled blood pressure and blood loss before and during surgery. After bypass and stenting, as long as there is no significant myocardial ischemia, echocardiographic ejection fraction of 60 or more can still be accepted for surgery.