Introduction: Degenerative spine disease is a common cause of healthcare utilization, and age is often presented as an independent risk factor for poor surgical outcome. As the average age of the US population increases, the burden of this disease will also increase, making it important to evaluate the actual influence of age on surgical outcomes.
Methods: We retrospectively reviewed data from our prospective registry of spine outcomes; we found 138 consecutive patients with cervical spine degeneration who underwent surgery between 2009 and 2013 at our institution. 116 patients (84.05%) had complete HRQOL (health-related quality of life) data at a minimum of 2-year follow-up. Mean age was 60.43 ± 10.81. Patients were divided into two age groups: 65 years or older (53 patients) and under 65 years of age (85 patients). We evaluated differences in the clinical features and surgical outcomes between the two groups.
Results: There were no significant differences in length of hospital stay, perioperative complications or discharge to home between patients over or under 65 years old. Although there were significant differences between surgical times, operated levels, and blood loss, both populations presented significant mean improvements in SF-36 Physical Composite Score (PCS), Visual Analog Scale (VAS) for neck pain, and Neck Disability Index (NDI), and crossed the desired MCID threshold at 1- and 2-year follow-up. Contrary to the younger group, the group over 65 years of age did not show a significant mean change in the SF-36 Mental Composite Score (MCS) (4.17±14.45 vs. 6.60±11.27). There was no difference in clinical outcomes between patients over 65 years old who developed complications post-surgery and those who did not.
Conclusions: The results of this study support the efficacy of surgery for degenerative cervical spine disease in patients over 65 years of age. The occurrence of perioperative complications did not adversely affect clinical outcome, and both groups achieved the desired MCID.
Patient Care: Age is often presented as an independent risk factor for poor surgical outcome. The results of this study support the efficacy of surgery for degenerative cervical spine disease in patients over 65 years of age. Given the growing population and increasing expectations of older patients, the utility of surgical treatment in this demographic group is critically important.
Learning Objectives: 1. The learner will be able to recognize the lack of a significant effect of age on surgical outcomes in degenerative cervical spine disease.
2. The learner will observe that perioperative complications did not significantly affect surgical outcomes in patients over 65 years of age.