The Impact of Age on Patient Reported Outcome Measures after Posterior Cervical Decompression and Fusion.
Publication/Presentation Date
9-22-2025
Description
STUDY DESIGN: Retrospective Cohort.
OBJECTIVE: Evaluate the impact of age amongst patients undergoing PCDF grouped by decades of age.
SUMMARY OF BACKGROUND DATA: Cervical degenerative disease disproportionately affects the elderly and is often treated with posterior cervical decompression and fusion (PCDF)- the impact of age on surgical and patient reported outcomes (PROMs) remains controversial.
METHODS: Adult patients 50-79 years old who underwent primary elective PCDF were retrospectively identified via Structured Query Language (SQL) search. Demographic and surgical data were verified with manual chart review. PROMs evaluated included Neck Disability Index (NDI), Visual Analog Scale (VAS) neck and arm, modified Japanese Orthopaedic Association (mJOA), and Short-Form 12 mental (MCS) and physical (PCS) scores. Patients were excluded if incomplete PROMs at preoperative and one-year postoperative timepoints or underwent PCDF for tumor/trauma/infection/revision. Patients were divided by decade (50-59,60-69,70-79 y) and statistical analysis set alpha=0.05.
RESULTS: 194 patients were included (ages 50-59-65; 60-69-87; 70-79-42). CCI (2.40 vs. 3.62 vs. 4.93; P< 0.001) and levels fused (3.37 vs. 4.25 vs. 4.64; P=0.005) increased with age. Despite these findings, the degree of improvement did not differ between groups for any PROMs. VAS neck and NDI scores were better at preoperative, 3-, 6-, and 12-month postoperative timepoints amongst the older decades compared to the younger decades (P< 0.05). Preoperative and 1-year postoperative MCS scores were higher in older age groups. All other MCS comparisons along with VAS arm, mJOA, and PCS did not differ between groups. Multivariable regression identified the 60-69 decade (estimate: -4.28; P=0.025) as independently associated with better 1-year NDI whereas the 70-79 decade was independently associated with both better 1-year NDI (estimate: -6.93; P=0.025) and 1-year MCS (estimate: 8.53; P=0.01).
CONCLUSION: Patients across older decades achieve similar improvement in PROMs following PCDF and may have better neck pain-related PROMs both pre- and postoperatively. These findings suggest that older patients, despite having more comorbidities and more extensive surgery, can receive similar mental, pain-related, and functional benefits from PCDF compared to younger patients.
ISSN
1528-1159
Published In/Presented At
Dalton, J., Olson, J., Huang, R., Carter, M., Toci, G., Green, W. A., Mahmood, H., Cha, R., Davis, M., Becsey, X., Culkin, M., Alvaro, C., Patel, K., Wilt, Z., Canseco, J. A., Hilibrand, A. S., Vaccaro, A. R., Kepler, C. K., & Schroeder, G. D. (2025). The Impact of Age on Patient Reported Outcome Measures after Posterior Cervical Decompression and Fusion. Spine, 10.1097/BRS.0000000000005510. Advance online publication. https://doi.org/10.1097/BRS.0000000000005510
Disciplines
Medicine and Health Sciences
PubMedID
40980859
Document Type
Article