To Örebro University

BACKGROUND: Global demographics show a steady increase in the number of octogenarians. Consequently, the number of degenerative spine procedures in the elderly has significantly increased. This study aims to describe patient satisfaction, the patient-reported health-related quality-of-life, and complications, following posterior cervical laminectomy for degenerative cervical myelopathy (DCM) in octogenarians based on the national Swedish experience.

METHODS: The national Swedish spine registry, Swespine was reviewed between January 2006 and December 2020 for patients who underwent laminectomy for DCM. Complication rates, patient satisfaction, and Patient-Reported Outcome Measures (PROMs) one year after surgery, were analyzed and compared between propensity score matched octogenarian (≥ 80) and younger adult cohorts (< 80 years).

RESULTS: A total of 1,382 patients, 162 octogenarians, and 1,220 younger patients were identified. At one-year after surgery there were no significant difference in patient satisfaction rate or in any of the other PROMS (Eq. 5D, NRS neck pain, NRS arm pain, EQ-VAS, Neck Disability Index (NDI), the European Myelopathy Score (EMS). Complication rates were also comparable, 8.0% in octogenarians (n = 13) and 11% in younger adults (n = 51), respectively. The length of hospital stay was significantly longer in the octogenarian group, with a mean hospitalization of 5.08 days (SD ± 4.86) compared to 3.76 days (SD ± 3.93) in the younger adult cohort (p < 0.001).

CONCLUSIONS: Octogenarians undergoing cervical spine surgery for DCM experience outcomes comparable to younger adults in terms of satisfaction, pain relief, and quality of life, indicating that age alone should not hinder surgical treatment.

LEVEL OF EVIDENCE: IV, Retrospective observational cohort study.