TITLE:
Spine Surgery Profile in the Fourth Age
AUTHORS:
Mohammad Sami Walid, Priyal Shah, Moataz Abbara, Nadezhda Zaytseva
KEYWORDS:
Spine Surgery, Fourth Age, Very Old, Old-Old, Older-Old
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.1 No.2,
October
31,
2011
ABSTRACT: As the population of the United States undergoes significant qualitative and quantitative changes the healthcare needs of the population changes accordingly. Since the “old-old” ≥85 years sector of the population is growing fast we embarked on studying how spine surgery profile changes across age groups. Methods: A database of 6147 spine surgery patients operated in a tertiary care center in Middle Georgia between 2003 and 2009 was divided to four age groups. The threshold for old-old age was set at 75. The percentage of old-old patients was calculated and their spine surgery profile for the whole period was studied. Changes in spine surgery profile were evaluated in relation to age group and gender. Type of surgery was determined by ICD-9 code. Results: For the whole study period, the percentage of old-old spine surgery patients was 6.7%. The percentage of old-old spine surgery patients increased from 4.7% in 2003 to 7.3% in 2009. Females were preponderant in the later three age groups (53.8%, 53.2% and 55.0%) while males were more in the 2 = 1446.958, P = 0.000). The spine surgery profile for the whole study period was characterized by shifts in the ≥75 age group toward less primary fusions of the cervical and lumbar spine and more refusions of the lumbar spine, more intervertebral disk excisions and more canal exploratory operations in older-old patients. In addition to the age factor, the gender factor had an impact on the spine surgery profile. Statistically significant differences (P