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Is it safe to perform lumbar spine surgery on patients over eighty five?
Houssam Bouloussa1, Abdulmajeed Alzakri2, Soufiane Ghailane3
1Department of Spinal Surgery Unit 1, Université de Bordeaux, Bordeaux University Hospital, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076, Bordeaux, France. houssam.bouloussa@gmail.com.
International Orthopaedics
|July 28, 2017
Summary
Lumbar spine surgery in patients over 85 is safe and well-tolerated, with high patient satisfaction and low mortality rates. Careful preoperative selection is crucial, as complications are common but mostly minor.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Geriatric Medicine
Background:
- Lumbar spine surgery is increasingly considered for elderly patients.
- Assessing the safety and outcomes of such procedures in the very elderly (over 85) is critical.
Purpose of the Study:
- To evaluate the safety and tolerance of lumbar spine surgery in patients aged 85 and above.
- To determine complication rates, survival, and patient satisfaction in this demographic.
Main Methods:
- Retrospective study of patients over 85 undergoing lumbar decompression with or without fusion.
- Data collected included comorbidities, autonomy scores (ADLs, Braden), surgical parameters, and complications (Clavien-Dindo).
- Telephone surveys assessed survival and satisfaction at long-term follow-up.
Main Results:
- Mean follow-up was 27.4 months; mean age was 87.5 years.
- A total of 49 complications were recorded (38.7% minor, 10.2% moderate, 12.2% major).
- Perioperative mortality was 0.02%, with 83.7% of patients reporting high satisfaction.
Conclusions:
- Advanced age (85+) is not an absolute contraindication for lumbar spine surgery.
- Careful preoperative patient selection is paramount for successful outcomes.
- While complication rates are high, most are minor, and patient satisfaction is notably high.
