Spine Surgeries in Elderly People

  •   Tue, Mar 14 2023
  •   By Dr Amrithlal A Mascarenhas

March 14, 2023

Spine surgeries in the elderly are becoming increasingly common as the population ages. But there is a lot of difference between a regular patient and a geriatric patient when it comes to undergoing spine surgery. People have common misconceptions that undergoing spine surgery means a wheelchair-bound life. Even though spine surgery is major surgery and the spine is central to the whole load of the body, the success rate of spinal surgeries is over 95%.

Elderly patients who undergo spine surgery often experience pain relief and improved mobility. Mostly, when a person brings an elderly patient to the hospital with spinal problems, they would have tried all kinds of treatment but have seen no success. In severe cases, he or she would be bedridden by the time they seek consultation. Thus, there should be an openness towards spinal surgery as it is a necessity irrespective of age and helps live a better quality of life.

However, there is a risk of complications from any surgery, so it is important to discuss the risks and benefits of surgery with your doctor before making a decision.

Approach to Spinal Surgeries in the Elderly

In spine surgery, the type of surgery depends on the kind of issue one has. The approach depends on pre-procedure discussion and planning of the surgery and deciding on what the proper principles and/or techniques can be used during the surgery. It also depends on the mental frame of the patient.

Since the spine is weak among older people, the focus is more on stabilizing the spine. The surgery may require putting up screws and rods in the spine to make it stronger and fix the problem. The most common type of surgery is laminectomy, which involves removing a portion of the vertebral bone to relieve pressure on the spinal cord or nerves. Other types of surgeries include spinal fusion, vertebroplasty, and discectomy.

The crux of successful spine surgery is always the support of the multi-disciplinary team in the ICU and the technology of management. With technological development in healthcare, minimally invasive procedures such as endoscopic spine surgery are being practiced widely by surgeons. The type of surgery performed will depend on the specific condition being treated, the location of the problem, and the patient’s overall health. People with other comorbidity issues can get treated with fast techniques and better monitoring systems. Spinal cord monitoring can monitor the spinal cord in real-time and help reverse and rectify any problem during surgery.

Challenges in Spine Surgeries in the Elderly

While these procedures can be successful in relieving pain and improving function, there are a number of challenges that come with performing spine surgeries in the elderly. They are more likely to have pre-existing medical conditions such as diabetes, hypertension, certain cancers, low immunity, weak bones (Osteoporosis), and risk of fractures, etc. Any of these conditions can complicate surgery and result in infections, bleeding, and blood clots which is why they and their relatives are hesitant to opt for surgery. Also, older people are more likely to have a longer recovery time and may need more rehabilitation after surgery.

Despite these challenges, spine surgery in the elderly can be successful. With proper planning and communication between the surgeon and the patient, elderly patients can experience significant improvements in their quality of life after surgery.

Preventing Spine Problems

In older people, falls are a leading cause of injury in the elderly, and they can often lead to serious injuries, such as hip fractures. To help prevent falls, the elderly should take steps to make their homes safe. This includes removing trip hazards, such as throw rugs and electrical cords, and installing grab bars in the bathroom. The elderly should also exercise regularly to improve their balance and strength.

Spinal problems have to be dealt with from early adulthood by maintaining a healthy lifestyle. However, older people can also adopt healthy habits like being active by walking as much as they can and eating a balanced diet.

Here are a few tips for adults to prevent any spinal conditions that may occur in the future:

• Exercise regularly. Take a walk for up to 4 km daily, cycle, or swim for half an hour. Consider weight training as well.
• Have a well-balanced diet and get proper exposure to sunlight.
• If you have a spine problem at a young age like a disc problem, ensure to deal with it appropriately.
• Women should have calcium and vitamins and address any menstrual dysfunction and hormonal issues.
• Don’t get into new exercises and do them rigorously because they may injure your health.


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By Dr Amrithlal A Mascarenhas
Dr Amrithlal A Mascarenhas is a consultant of spine surgery at Manipal Hospital Millers Road, Bengaluru.
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Comment on this article

  • Flavian, Mangalore/Kuwait

    Wed, Mar 15 2023

    I am the one who had spine surgery to fix my vertebra 4-5 in order to place my cen ral nerve back in original position which had protruded due to slip disk. That happened 12 yars back and I am perfectly in good health and confidence to live life without any killer pain which I went through for ages. I have have Platinum rod inserted and vertebras are supported with clamp an screws. I was discouraged by some private doctors not to go for surgery explaining me that success rate cannot be guaranteed and chances of on wheel chair may be inevitable. I had no second thought, I had trust in God and prayed that I will go ahead rather than suffering such killer and devastating pain. Thank God everything went precisely. Surgery lasted 12 hours and when I came out of operation theater there was a smile on my face and my fly was so happy. Prayers and doctors teamwork gave me second phase in life.

  • Rudolf Rodrigues, Mumbai

    Wed, Mar 15 2023

    Doc, nice, short, and lucid article. The term geriatric is a generic one and does not specify any age group; in that, how much minimal % of improvement attainable post procedure could be a prospective candidate for the procedure? Also for a person in his 80s would you still recommend a spinal procedure considering the risks involved? Also, would it be not prudent enough to take a second independent opinion before getting ready for the scalpel? I would be thankful if you could quench my curiosity. Thanks!


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