Complications Following Spinal Surgery in Patients Aged 85 Years and Older

Abstract

Objective Surgery is increasingly being performed in elderly patients owing to the aging society and the desire for an improved quality of life. We aimed to examine the perioperative complications of spinal surgery in such patients. Methods This study analyzed the surgical details and perioperative complications in 36 patients aged >85 years who underwent spinal surgery at a single tertiary medical center based on a review of a prospective database. Pre-existing medical illnesses were evaluated using the American Society of Anesthesiologists (ASA) physical status class, and age and surgical parameters were analyzed as factors potentially predictive of complications. Ambulatory function was rated on a 4-point Likert scale. Results During the study, 36 patients (mean age, 87 years) with a mean the ASA class of 2.31 ± 0.47 were enrolled. The mean number of levels treated was 2.06 ± 1.35, and 66% underwent minimally invasive surgery. The mean operative time was 144 ± 70.4 min. Ambulatory function improved significantly by 0.72 ± 0.97 points and visual analog scale scores by 1.88 ± 0.76 points. Twenty complications (19 of which were temporary, and one was permanent) occurred. Patient age, operation time, the ASA class, number of treated patients, and minimally invasive surgery were not significantly associated with complications. Conclusion Spine surgery in patients 85 and older can be accomplished safely if careful attention is paid to preoperative patient selection. Key words: Aged; Delirium; Neurosurgical procedures; Spine