Introduction: Age is often presented as an independent risk factor for poor surgical outcome and a reason to avoid operative management of spinal disease in the elderly. To date, there has been limited prospective analysis of age as a risk factor for worse patient outcomes following degenerative spine surgery.
Methods: From 2009 to present, all patients being evaluated for an operation for cervical or lumbar degenerative disease at the University of Chicago Spine Clinic were asked to fill out a questionnaire evaluating patient outcome at 3, 6, 12 and 24 months postoperatively. Patient instruction and data collection were performed by an individual separate from the medical team, and the providers were blinded to the results. Data analysis was performed on questionnaire responses at 12 months from the surgery for a total of 275 patients. Patients were categorized by age divided into decades. Outcome ratings on a 7 point Likert-type scale were analysed, in which lower scores indicated better outcomes.
Results: There was no statistically significant difference when patient outcomes were analyzed decade by decade (range 25-90 years old) The mean outcome score did not differ significantly between male (n=144, mean=23.4, std dev=9.87) and female patients (n=131, mean=24.9, std dev=11.82). In addition, the mean outcome score did not differ between cervical (n=106, mean=24.5, std dev=10.36) and lumbar procedures (n=169, mean=23.9, std dev=11.17).
Conclusions: Age was not a significant predictor of patient outcomes at 12 months after spinal surgery for degenerative disease. We conclude that the potential effect of age on outcome was smaller than individual variability. Advanced age alone should not be a deterrent to offering spinal surgery in properly selected patients.
Patient Care: It provides evidence that elderly patients perceive a similar benefit from surgical management of degenerative spine disease as their younger cohorts, which can influence physician-patient communication and medical decision-making.
Learning Objectives: 1. The learner will be able to recognize the variability of patient outcome in surgery for degenerative spine and the lack of a significant effect of age, gender or site of the operation.