Should We Operate on Octogenarians With Cervical Myelopathy or Radiculopathy?

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Geriatric Medicine

Background:

• Increasing demand for elective cervical spine surgery in aging populations.
• Limited data on outcomes for octogenarians undergoing cervical spine surgery.
• Concerns regarding age-related complexities in surgical management.

Purpose of the Study:

• To investigate disparities in perioperative and postoperative outcomes between octogenarians and nonoctogenarians undergoing cervical spine surgery.
• To compare complication rates, readmissions, and reoperations.
• To evaluate patient satisfaction and patient-reported outcome measures (PROMs).

Main Methods:

• Retrospective cohort study design.
• Propensity matching of octogenarians (n=29) to younger patients (n=87) at a 3:1 ratio.
• Analysis of primary outcomes: postoperative complications, 90-day readmissions, 12-month reoperations; secondary outcomes: PROMs and patient satisfaction.

Main Results:

• No significant differences in postoperative complications (10.3% vs. 6.9%), 90-day readmissions (10.3% vs. 6.9%), or 12-month reoperations (3.4% vs. 2.3%) between cohorts.
• Comparable 12-month patient satisfaction (65.2% vs. 55.3%) and achievement of minimal clinically important differences (MCID) in PROMs.
• Mean age was 82.4±2.2 years for octogenarians and 59.1±11.1 years for nonoctogenarians.

Conclusions:

• Octogenarians undergoing elective cervical spine surgery achieve outcomes comparable to younger patients.
• Postoperative complications, readmission rates, reoperation rates, and PROMs do not significantly differ by age.
• Age alone should not preclude patients from undergoing elective cervical spine surgery.