Introduction: A large scale study comparing patients aged greater than 80 to younger patients has not been performed regarding the post-operative complications of lumbar fusion surgery for spondylolisthesis. The purpose of this study is to assess the effects of extreme age (greater than 80) on early post-operative outcomes after single-level lumbar fusions for spondylolisthesis.

Methods: A total of 2,475 patients who underwent a single-level lumbar fusion procedure for spondylolisthesis were selected retrospectively from a validated multi-center surgical database. A cohort with 227 patients greater than 80 years of age was compared with a typically aged cohort with 2,248 patients between 45-65 years.

Results: The preoperative characteristics and comorbidities were different between the typical aged cohort versus the 80+ cohort, with older patients having more preoperative comorbidities, including a lack of independent functional health status prior to surgery (p<0.001), severe COPD (p<0.020), and hypertension requiring medication (p<0.001). There was significantly greater morbidity among the 80+ cohort regarding urinary tract infection (p=0.008, OR: 3.30, CI: 1.47-7.40) and intra/postoperative transfusions (p<0.001, OR: 2.186, CI: 1.54-3.11). There was significantly greater morbidity among the younger cohort regarding cardiac arrest requiring CPR (p=0.043, OR: 0.099, CI: 0.014-0.704).

Conclusions: This is the first large study comparing the rates of post-operative complications of lumbar fusion surgery for spondylolisthesis in patients aged 80 and above to younger patients. The data support that age alone should not exclude a patient for this procedure. However, extra caution is warranted given the slightly increased morbidity.

Patient Care: In this manuscript, we discuss the post-operative complications of lumbar fusion surgery for spondylolisthesis in patients over the age of eighty. After performing an exhaustive search and review of the literature, to the best of our knowledge we have carried out the first large study of the safety profile for this procedure in patients aged greater than 80 to younger patients.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of developing approach treatment algorithms for the elderly as the population continues to age. 2) Discuss, in small groups, a comparison of morbidity and mortality between middle aged and elderly cohorts. 3) Identify an effective treatment for spondylolisthesis in the elderly.

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