LAUSR

INTRODUCTION Advancements in modern medicine have led to longer life expectancy in the elderly population. Literature on spinopelvic fixation in the elderly is limited. We investigated morbidity and mortality in octogenarians who underwent spinopelvic fixation. METHODS A retrospective chart review was conducted on patients who underwent spinopelvic fixation from January 2014 through December 2018 at a single institution. Patients were grouped into the Octogenarian group (OG, age 80-89) and comparison group (CG, age 40-50). Demographics, pathology, Charlson Comorbidity Index (CCI), Hounsfield units (HU), details of surgery, and clinical data including complications, ICU and length of hospital stay, and mortality were collected and compared. RESULTS A total of 26 patients met inclusion criteria (n=14 OG, n=12 CG). Diagnoses in the OG were deformity (42.9%), pseudoarthrosis (35.7%), fracture (7.1%), infection (7.1%), and tumor (7.1%). The only significant differences in baseline patient characteristics were that CCI was significantly higher in the OG (6.0 ± 1.4) compared to the CG (1.1 ± 1.0), (p<0.001) and the OG had lower HU (p<0.001), indicating poorer bone quality. More patients in the CG underwent staged and anterior approaches compared to the OG (p=0.031). The major and minor complication rates in the OG were 57.1% and 42.9%, respectively, and 25% and 25% in the CG (p=0.98, p=0.34). Mortality rate was 14.3%. CONCLUSION With an aging population, the number of patients requiring spinopelvic fixation will continue to grow. However, spine surgeons must carefully weigh benefits and risks in patients with multiple comorbidities.