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Study design <p>Retrospective multicenter study.</p> Objectives <p>To evaluate the safety and efficacy of adult spinal deformity (ASD) surgery in patients aged ≥ 80 years compared to their younger counterparts.</p> Methods <p>Patients who underwent posterior fusion involving ≥ 5 spinal levels for ASD between 2017 and 2023 at two institutions were included. Patients were stratified into the three groups categorized by age: super-elderly (≥ 80 years), elderly (65–79 years), and middle-aged (50–64 years). Demographics, surgical details, radiographic parameters, patient-reported outcomes, satisfaction at two years, 30-day complications, and rates of proximal junctional failure (PJF) were compared.</p> Results <p>A total of 151 patients (44 super-elderly, 79 elderly, and 28 middle-aged) were analyzed. Super-elderly patients had higher ASA scores and a higher rate of osteoporosis than the other groups. Surgical extent and duration were similar, but blood loss was lower in the super-elderly group. Pre-operative PT and SVA as well as post-operative PT were significantly greater in the super-elderly and elderly groups than in the middle-aged group. Leg pain and ODI were significantly worse pre-operatively in the elderly group; however, all post-operative outcomes, satisfaction, short-term complication rates were similar across the three groups. The incidence of PJF increased stepwise across age categories (36% vs. 29% vs. 12%, <i>p</i> = 0.09), while a multivariate analysis revealed super-elderly status was not independently associated with PJF.</p> Conclusions <p>Despite greater pre-operative deformity, patients aged ≥ 80 years achieved comparable functional and radiographic outcomes to patients aged 65–79 and 50–64. Careful patient selection and pre-operative counseling are essential for optimizing outcomes in this growing surgical population.</p>

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Outcomes of adult spinal deformity surgery in octogenarians - How old is too old? 

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月7日

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  • So Kato,
  • Yuki Taniguchi,
  • Naohiro Kawamura,
  • Yusuke Sato,
  • Yuki Onishi,
  • Yuta Nakayama,
  • Hideki Nakamoto,
  • Kosei Nagata,
  • Hiroyuki Nakarai,
  • Sakae Tanaka,
  • Yasushi Oshima

摘要

Study design

Retrospective multicenter study.

Objectives

To evaluate the safety and efficacy of adult spinal deformity (ASD) surgery in patients aged ≥ 80 years compared to their younger counterparts.

Methods

Patients who underwent posterior fusion involving ≥ 5 spinal levels for ASD between 2017 and 2023 at two institutions were included. Patients were stratified into the three groups categorized by age: super-elderly (≥ 80 years), elderly (65–79 years), and middle-aged (50–64 years). Demographics, surgical details, radiographic parameters, patient-reported outcomes, satisfaction at two years, 30-day complications, and rates of proximal junctional failure (PJF) were compared.

Results

A total of 151 patients (44 super-elderly, 79 elderly, and 28 middle-aged) were analyzed. Super-elderly patients had higher ASA scores and a higher rate of osteoporosis than the other groups. Surgical extent and duration were similar, but blood loss was lower in the super-elderly group. Pre-operative PT and SVA as well as post-operative PT were significantly greater in the super-elderly and elderly groups than in the middle-aged group. Leg pain and ODI were significantly worse pre-operatively in the elderly group; however, all post-operative outcomes, satisfaction, short-term complication rates were similar across the three groups. The incidence of PJF increased stepwise across age categories (36% vs. 29% vs. 12%, p = 0.09), while a multivariate analysis revealed super-elderly status was not independently associated with PJF.

Conclusions

Despite greater pre-operative deformity, patients aged ≥ 80 years achieved comparable functional and radiographic outcomes to patients aged 65–79 and 50–64. Careful patient selection and pre-operative counseling are essential for optimizing outcomes in this growing surgical population.