JMIR Publications

ABSTRACT

Background:

Minimally invasive posterior lumbar interbody fusion (MIS-PLIF) is commonly used to treat degenerative lumbar spine conditions. Patients of advanced age often present with multiple comorbidities and reduced physiological reserves, influencing surgical risks and recovery.

Objective:

The study aimed to identify associations between different age groups and outcomes of MIS-PLIF.

Methods:

This study analyzed data from the United States Nationwide Inpatient Sample (NIS) from 2016 to 2020, conducted retrospectively. Patients ≥ 60 years old who received MIS-PLIF were eligible for inclusion. Patients were categorized by age into the groups 60-69, 70-79, and ≥ 80 years old. Logistic and linear regressions were employed to determine the associations between the study variables and outcomes, including in-hospital mortality, complications, non-routine discharge, and length of stay (LOS).

Results:

A total of 785 patients ≥ 60 years old (mean age: 69.4 years) who received MIS-PLIF were included in the analysis, and 18.7% experienced at least one complication. After adjustment, compared to patients aged 60 to 69 years, the risk of non-routine discharge was significantly increased in patients aged 70-79 years (adjusted odds ratio [aOR] = 2.33, 95% confidence interval [CI]: 1.57-3.46, p < 0.001) and ≥ 80 years (aOR = 4.79, 95% CI: 2.64-8.67, p < 0.001)). No significant differences in the risk of complication or LOS were observed across age groups.

Conclusions:

In older patients undergoing MIS-PLIF, advanced age is an independent predictor of non-routine discharge. Nevertheless, age alone appears to be not associated with increased risk of complications or prolonged hospitalization. These findings underscore that MIS-PLIF is a viable option for older patients, where extra attention may still be needed for postoperative care.