Frontiers in medicine · 2026
Spinal metastases in geriatric patients: a retrospective single-center comparison of mortality and surgical outcomes following neurosurgical treatment.
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Abedellatif Saif-Eldin, Janjic Marija, Khalafov Logman, Asoglu Harun, Dittmer Juliane, Alenezi Haitham, Maiseyeu Ivan, Jaber Mohammed, Heimann Muriel, Lampmann Tim, Schneider Matthias, Vatter Hartmut, Hamed Motaz, Banat Mohammed
Аннотация
BACKGROUND: Spinal metastases (SM) are increasingly common. In an aging population, this trend raises concerns regarding the safety and efficacy of surgical treatment (ST) in geriatric patients. This study aimed to compare postoperative outcomes, complications, recurrence, readmission, and mortality between geriatric and non-geriatric patients undergoing ST for SM.
METHODS: Our retrospective cohort study included 277 patients who underwent ST for SM between 2012 and 2024. Patients were stratified into non-geriatric (< 70 years, n = 161) and geriatric (≥ 70 years, n = 116) groups. Clinical and surgical parameters, including complications, recurrence, readmission, and survival, were analyzed.
RESULTS: Geriatric patients had a higher preoperative comorbidity burden and lower functional status. However, early outcomes, such as postoperative complications, readmission rates, and local tumor recurrence, did not differ significantly between age groups. Median overall survival was 12.0 months in patients < 70 years and 10.5 months in patients ≥ 70 years (p = 0.026). The multivariable analysis shows that obesity (p = 0.028), Surgical stabilization (p = 0.043), prolonged postoperative mechanical ventilation (p = 0.041), early surgical complications (p = 0.009), and a preoperative Karnofsky Performance Scale < 70% (p = 0.036) were independently associated with increased 1-year mortality in geriatric patients.
CONCLUSION: Our data demonstrates that geriatric patients undergoing ST for SM did not experience worse early postoperative outcomes. Careful patient selection based on functional status and perioperative risk factors remains essential.
METHODS: Our retrospective cohort study included 277 patients who underwent ST for SM between 2012 and 2024. Patients were stratified into non-geriatric (< 70 years, n = 161) and geriatric (≥ 70 years, n = 116) groups. Clinical and surgical parameters, including complications, recurrence, readmission, and survival, were analyzed.
RESULTS: Geriatric patients had a higher preoperative comorbidity burden and lower functional status. However, early outcomes, such as postoperative complications, readmission rates, and local tumor recurrence, did not differ significantly between age groups. Median overall survival was 12.0 months in patients < 70 years and 10.5 months in patients ≥ 70 years (p = 0.026). The multivariable analysis shows that obesity (p = 0.028), Surgical stabilization (p = 0.043), prolonged postoperative mechanical ventilation (p = 0.041), early surgical complications (p = 0.009), and a preoperative Karnofsky Performance Scale < 70% (p = 0.036) were independently associated with increased 1-year mortality in geriatric patients.
CONCLUSION: Our data demonstrates that geriatric patients undergoing ST for SM did not experience worse early postoperative outcomes. Careful patient selection based on functional status and perioperative risk factors remains essential.