Saudi Arabia's King Abdullah Leaves NY Hospital in Good Health

NEW YORK -- Saudi Arabia's 86-year-old King Abdullah has been discharged from a New York City hospital in good health after two back operations and, one expert says, faces a painful recovery that will likely involve weeks of physical therapy.

Though back surgery on a patient of Abdullah's age is unusual, it's becoming more common due to better surgical techniques and patients living longer, healthier lives, said Dr. Lawrence Chin, neurosurgeon-in-chief at Boston Medical Center. Still, surgery is riskier for older patients, and the recovery takes longer.

"There's no question the risks are higher, but we are much better as surgeons and doctors, so we can do surgery safely on older patients now," said Chin, who was not involved in Abdullah's care.

Saudi Arabia has more than 25 percent of the world's known oil reserves, so the health of the royal family and a possible power void could have implications worldwide.

The king had an operation at NewYork-Presbyterian Hospital last month for a slipped disk and a blood clot pressing on back nerves, The Associated Press reported, and a second operation this month to stabilize several vertebrae.

"King Abdullah left the Presbyterian Hospital on Tuesday evening ... as God gave him good health," the Saudi Press Agency said today, the BBC reported. "He moved to his residence in New York to recuperate and continue with physical therapy."

A spokeswoman for NewYork-Presbyterian said Abdullah was discharged Tuesday but had no comment on his treatment or condition.

The greatest risk from surgery is anesthesia, which could lead to a heart attack or stroke if a patient's blood pressure changes too quickly. This risk is exacerbated in older patients who may have high blood pressure or sensitivity to medications, Chin said.

"Any time you're dealing with someone in their 80s, they're much more difficult to manage, and the risks of anesthesia are much higher," said Chin, a professor and chair of the neurosurgery department at Boston University School of Medicine.

An uncomplicated disk operation usually keeps patients in the hospital for a day, perhaps two to three days for an older patient, Chin said. The longer, more complicated stabilization surgery, in which screws, rods and bone chips are usually inserted in the spine to help fuse the bones, can keep an older patient hospitalized for up to a week, he said.

After both operations, patients generally would leave the hospital able to move around, but the fusion surgery usually requires physical therapy for four to six weeks to help patients walk and regain their flexibility, Chin said. Once home from stabilization surgery, patients would likely be on pain medication and wear a brace around their abdomen to help stabilize the back, he said.

The biggest post-surgical complications for older patients is wound healing, which takes longer and leaves more time for an infection to develop, and difficulty with mobility. Patients who can't get out of bed could develop pneumonia or potentially deadly embolisms that travel to the lungs, he said.

Older patients can be more sensitive to medicine, which could knock them out or make them confused or lightheaded and lead to a fall.

"There are numerous, numerous risks with operating on older patients, and these risks, they all add on top of each other," Chin said. "Each step is compounded by the other risks. That's why it's so risky to operate on an older patient."

But the risks are counteracted by the fact that patients now take better care of themselves and are able to tolerate the surgery, Chin said. More patients are now having back surgery into their 80s and even 90s, he said.

"It used to be that you wouldn't think of doing surgery on people 70 or 75," said Chin, who performs back surgery. "Now if they're 85 or 90 and in good shape, I'll definitely consider surgery. That ceiling for doing surgery has risen quite a bit."

There's been no word on how long Abdullah will spend recovering in New York. He arrived on Nov. 22, leaving his half-brother, Crown Prince Sultan, in charge of the kingdom while he was away. The BBC noted that Sultan is also in his 80s and has suffered from poor health.