• Omar Zakieh, Maryam Jawid, Mitchell Bowers, Mason Young, Scott L Zuckerman, Julian G Lugo-Pico, Raymond J Gardocki, Amir M Abtahi, and Byron F Stephens.
• Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
• Spine. 2024 Dec 2.

Study DesignRetrospective Cohort.ObjectiveInvestigate the disparities between octogenarians and non-octogenarians undergoing cervical spine surgery regarding perioperative, and postoperative outcomes.Summary Of Background DataAs the population ages, the demand for elective cervical spine surgery among older, more active adults increases. However, concerns remain regarding the optimal management of older patients undergoing cervical surgery, given the potential complexities associated with advanced age, comorbidities, and physiological decline. While the safety and efficacy of cervical spine surgery in younger cohorts have been extensively studied, there is a paucity of literature specifically addressing outcomes in octogenarians.MethodsOctogenarians undergoing elective cervical spine surgery were propensity matched 3:1 to patients <80 years old by baseline neck and arm pain, surgical approach, and total instrumented levels. Primary outcomes of interest were postoperative complications, unexpected 90-day hospital readmissions and 12-month reoperation. Secondary outcomes were 12-month patient satisfaction and patient reported outcome measures (PROMs) at 3 and 12 months, including EuroQol-5D, modified Japanese Orthopaedic Association, neck disability index, and visual analog scale for neck and arm pain.ResultsThere were 29 octogenarians and 87 nonoctogenarians identified. The mean age in each cohort was 82.4±2.2 vs. 59.1±11.1 years, respectively. There was no difference in postoperative complications (10.3% vs. 6.9%, P=0.548), 90-day readmission (10.3% vs. 6.9%, P=0.548), and 12-month reoperation (3.4% vs. 2.3%, P=0.736) between octogenarians and non-octogenarians. Similarly, octogenarians and nonoctogenarians experienced comparable 12-month patient satisfaction (65.2% vs. 55.3%, P=0.393), improvement in 3- and 12- month PROMs and MCID achievement.ConclusionPostoperative complications, readmission, reoperation rate, patient satisfaction, and PROMs did not significantly differ between octogenarians and non-octogenarians undergoing cervical spine surgery. These findings suggest that age alone should not be a determining factor in surgical decision-making for elective cervical spine procedures, as octogenarians can achieve comparable outcomes to their younger counterparts.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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