Long-term clinical outcomes following surgical management of cervical spine fractures in elderly patients

Abstract

Background: To date, no studies have compared the outcomes of surgical management of cervical fractures in patients<75 to those of patients≥75. Given the possibility of increased frailty in “older” elderly patients, it is important to consider how the outcomes of surgery compare in these two patient groups. Objective: In this study, we aim to determine if the outcomes of surgical management of cervical fractures differ when comparing patients<75 to patients≥75. Methods: A retrospective review was conducted of a prospectively maintained database of 107 elderly patients who experienced cervical spine trauma between 2007 and 2014. Chi-square analysis and Fisher exact tests were performed to compare two groups on a number clinical outcome measures. Results: There are no statistically significant differences when patients<75 with patients≥75 on a number of clinical outcome measures. Selected outcomes include length of stay, likelihood of death during admission, likelihood of death following discharge, likelihood of developing mental status decline following discharge, post-operative neurologic improvements, and long-term functional status. Conclusions: Patients≥75 have statistically similar outcomes following surgical management of cervical spine fractures when compared to patients<75. This may be due to ongoing improvements in both surgical and medical methodologies in spine trauma care. These results indicate that surgical management of cervical fractures in elderly patients is beneficial without regard to age, and should not be withheld for fear of poor outcomes in “older” elderly patients. Keywords: Cervical, Elderly, Fracture, Morbidity, Outcomes, Spine, Trauma