Patient-reported Outcomes in Super-elderly Patients over 90 Years of Age with Degenerative Spinal Diseases: A Multicenter Study

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Introduction: Due to global increases in life expectancy, numbers of both super-elderly patients (≥90 years old) and the spine surgeries they undergo are increasing. However, no studies on spine surgery for super-elderly patients have focused on patient-reported outcomes (PROs).

Methods: Subjects were elderly patients (over 75 years old) undergoing spine surgery for degenerative disease (4408 cases) performed at our 13 affiliated centers between April 2017 and August 2021. Surgical procedures, perioperative complications, and PROs were investigated and compared between patients ≥90 years old (SE group) and control patients 75–89 years old (E group).

Results: Although the two groups showed no significant differences in patient background, the SE group showed significantly fewer fusions. The incidence of perioperative complications, including death within 30 days, did not significantly differ between groups. Regarding PROs, there were no significant differences in percentages of patients who achieved minimum clinically important differences in Neck Disability Index, Oswestry Disability Index, or EuroQoL 5 Dimension. There were no significant differences in pre- and postoperative numeric rating scales for each item or patient satisfaction.

Conclusions: There were significant improvements in PROs at 1 year postoperatively in the SE group than in the E group, and there were no significant differences in perioperative complication rates or mortality.