Age-Stratified Analysis of Posterior Lumbar Fusion Surgeries: Revealing Unique Surgical Patterns and Outcomes in an Aging Population.
Publication/Presentation Date
4-6-2026
Abstract
STUDY DESIGN: Retrospective Cohort.
OBJECTIVE: Compare surgical characteristics, complications, and patient-reported outcome measures (PROMs) by clinically relevant and easily applicable age-decade groups after posterior lumbar decompression and fusion surgery (PLDF).
SUMMARY OF BACKGROUND DATA: Due to an aging population and an increased utilization of spine surgery, spine surgeons must increasingly consider age as a variable that affects surgical risk and outcomes.
METHODS: Patients undergoing primary/elective PLDF at one tertiary center (2017-2021) were included. Outcomes included rates of in-hospital and 30-day mortality, 90-day readmission, 1-year revision, and PROMs- Oswestry Disability Index, SF-12 Physical (PCS) and Mental Component Summary (MCS), and Visual Analog Scale (VAS): Back and Leg. Patients were stratified and compared by age decade.
RESULTS: 1100 patients were included (Age: < 50-N=90, 50-59-N=212, 60-69-N=385, 70-79-N=334, ≥80-N=79). Increasing age decade was associated with lower BMI. Comorbidities, levels decompressed and fused increased with age decade until 70 then slightly decreased. Patients ≥80 predominantly received PLDF, while those < 50 predominantly received TLIF/PLDF. Decade groups were similar regarding rates of in-hospital/30-day mortality, 90-day readmission, 1-year revision, and all PROMs except 6-month and 1-year postoperative MCS. Patients aged 70-79 displayed the best 6-month and 1-year postoperative MCS scores. On multivariable regression, age ≥80 best predicted increased LOS (β=0.89; P< 0.001) and non-home discharge (β=3.05; OR=21.17; P< 0.001) after accounting for sex, BMI, Charlson Comorbidity Index, operative time, and number of levels fused; age 60-79 showed weaker prediction.
CONCLUSION: Following PLDF, older patients had similar postoperative mortality, readmission, revision, and PROM improvement; however increasing age predicted increased LOS and non-home discharge. These results suggest that patients in advanced age decades derive similar benefits to their younger counterparts, while maintaining an appropriate safety profile. Future studies should further elucidate age-related outcome differences to improve risk stratification and patient counseling.
ISSN
1528-1159
Published In/Presented At
Dalton, J., Tomlak, A., Ng, M., Mathew, J., Giakas, A., Oris, R. J., Alexander, T., Narayanan, R., Pohl, N. B., Green, W. A., Schoenberg, M., Gaccione, L., Syed, A., Mula, M., Kurd, M. F., Kaye, I. D., Rihn, J. A., Canseco, J. A., Hilibrand, A. S., Vaccaro, A. R., … Schroeder, G. D. (2026). Age-Stratified Analysis of Posterior Lumbar Fusion Surgeries: Revealing Unique Surgical Patterns and Outcomes in an Aging Population. Spine, 10.1097/BRS.0000000000005712. Advance online publication. https://doi.org/10.1097/BRS.0000000000005712
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41945607
Department(s)
Administration and Leadership
Document Type
Article