• Esteban Quiceno, Scott Seaman, Amna Hussein, Nikhil Dholaria, Annie Pico, Ebtesam Abdulla, Isabel L Bauer, Kristin Nosova, Alexandros Moniakis, Monis Ahmed Khan, Courtney Deaver, Giovanni Barbagli, Michael Prim, and Ali Baaj.
• Banner University Medical Center Phoenix USA, University of Arizona Department of Neurosurgery, Phoenix, Arizona, USA. Electronic address: equicenor@gmail.com.
• World Neurosurg. 2024 May 1; 185: e878e885e878-e885.

ObjectiveThe 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.MethodsThis 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 (CCI), 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.ResultsAmong 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%) postoperative complications were documented, with no statistically significant differences observed between the groups.ConclusionsThis 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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