Safety and Outcomes of Elective Spine Surgery in the Super-Elderly (Over 85) Patient Population

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Brain and Spine

Abstract

Degenerative changes continue to progress in the cervical and lumbar spine with advancing age, resulting in compromised mobility and increased fall risk with its associated morbidities. As life expectancy increases and a greater number of individuals live beyond 85, more individuals will present with spinal conditions which may benefit from surgical treatment. Currently, the potential benefits and complications resulting from spinal surgery in individuals older than 85, or “super-elderly” individuals, is not well understood. Methods All patients over age 75 undergoing elective cervical or lumbar spinal surgery for degenerative conditions with a minimum of one year follow-up over a three-year period ending in December of 2022 were retrospectively reviewed. Indications, intraoperative data and post-operative outcomes were compared between patients 75 to 85 years old with those older 85. These included changes in pain VAS, pre/postoperative MME use, pre/postoperative neurological exams, pre/ postoperative patient mobility/ambulation status, EBL, LOS, and AE. Results A total of 103 patients (87 ages 75-85 and 16 ages 85 and older) were identified. There were no statistically significant differences between the groups in terms of gender, ASA score, preoperative diagnoses (spondylosis, spondylolisthesis, stenosis), preoperative VAS for back pain, preoperative MME, motor examination, or sensory examination. There were no statistically significant differences in the type of procedure performed (decompression alone or decompression and fusion), the approach (posterior, lateral, or anterior), operative technique (open or minimally invasive) or intraoperative EBL. There were no statistically significant differences between the two groups in post-operative outcomes including post-operative MME, pain VAS, motor examination, sensory examination, or ambulation status. However, there was a statistically significant difference between the two groups when comparing the improvement in ambulation status from preop to postop and comparing improvement in lower extremity motor strength from preop to postop. In both factors the over 85 group had a statistically significant greater degree of improvement than the 75 to 85 group (p< 0.05). There were no statistically significant differences in length of stay, early (less than thirty days) or late (greater than thirty days) AE or any differences in minor or major AE (major AE were categorized as those that were life-threatening, required reoperation, or required IV antibiotics). Conclusions Elective spine surgery for the super-elderly (older than 85) does not appear to be associated with a greater risk of adverse events than elective spine surgery during the prior decade of life. The benefits of surgery in the super elderly do not appear to be less significant than their slightly younger cohort. Furthermore, the super elderly may even experience more significant improvements in motor strength and mobility/ambulation status with operative intervention. Elective spine surgery should not be withheld in this patient population based on age alone.

Volume

5

Issue

Suppl 2

First Page

243

Comments

EANS (European Association of Neurosurgical Societies) 2025 Congress, October 5-9, 2025, Vienna, Austria

Last Page

243

DOI

10.1016/j.bas.2025.105520

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