Clinical Outcomes and Complication Profile of Spine Surgery in Septuagenarians and Octogenarians: Case Series

Introduction The aging global population presents an increasing challenge for spine surgeons. Advancements in spine surgery, including minimally invasive techniques, have broadened treatment options, potentially benefiting older patients. This study aims to explore the clinical outcomes of spine surgery in septuagenarians and octogenarians. Methods This retrospective analysis, conducted at a US tertiary center, included patients aged 70 and older who underwent elective spine surgery for degenerative conditions. Data included the Charlson Comorbidity Index, ASA classification, surgical procedures, intraoperative and postoperative complications, and reoperation rates. The objective of this study was to describe the outcomes of our cohort of older patients and discern whether differences existed between septuagenarians and octogenarians. Results Among the 120 patients meeting the inclusion criteria, there were no significant differences in preoperative factors between the age groups(p>0.05). Notably, the septuagenarian group had a higher average number of fused levels(2.36 vs. 0.38, p=0.001), while the octogenarian group underwent a higher proportion of minimally invasive procedures(p=0.012), resulting in lower overall bleeding in the oldest group(p<0.001). Mobility outcomes were more favorable in septuagenarians, whereas octogenarians tended to maintain or experience a decline in mobility(p=0.012). A total of 6(5%) intraoperative complications and 12(10%) post-operative complications were documented, with no statistically significant differences observed between the groups. Conclusion This case series demonstrates that septuagenarians and octogenarians can achieve favorable clinical outcomes with elective spine surgery. Spine surgeons should be well-versed in the clinical and surgical care of older adults, providing optimal management that considers their increased comorbidity burden and heightened fragility.