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Spinal surgery in older people: indications, techniques and outcomes

  • ADL Baker (a1) and P Sanderson (a1)


This article provides an overview of spine surgery in older people and reviews outcome and novel techniques. Improvements in pain, disability, and quality of life can be expected following surgery and demand for surgery of this type is likely to increase as the mean age of the population increases. Novel techniques and improved intsrumentation offer surgical treatments for conditions that were previously untreatable and show encouraging early results.


Corresponding author

Address for correspondence: Mr ADL Baker, Department of Orthopaedic Spine Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP. Email:


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1Aebi, M, Gunzburg, R, Szpalski, M. The aging spine. Eur Spine J 2003; 12: (suppl 2): 13.
2Weinstein, JN et al. Trends in spine surgery. Spine 2006; 31: 2207–14.
3Boos, N, Weissbach, S, Rohrbach, H, Weiler, C, Spratt, KF, Nerlich, AG. Classification of age related changes in intervertebral discs. Spine 2002; 27: 2631–44.
4Roberts, S, Caterson, B, Menage, J, Evans, EH, Jaffray, DC, Eisenstein, SM. Matrix metalloproteinases and agrecanase: their role in disorders of the human intervertebral disc. Spine 2000; 25: 3005–13.
5Aebi, M, Arlet, V, Webb, J. AO Spine Manual. Thieme, 2007. ISBN 1588905578.
6Frymoyer, J. The Adult Spine: Principles and Practice. Lippincott Williams & Wilkins; 2nd edn, 1997. ISBN 0781703298.
7Nadeau, M, Arellano, P, Gurr, K et al. The reliability of differentiating neurogenic claudication from vascular claudication based on symptomatic presentation. Can J Surg 2010; 53 (suppl): S2648.
8Sanderson, P, Wood, P. Surgery for lumbar spinal stenosis in old people. J Bone Joint Surg (Br) 1993; 75B: 393–97.
9Weinstein, JN, Lurie, JD, Tosteson, TD, Zhao, W, Blood, EA, Tosteson, AN, Birkmeyer, N, Herkowitz, H, Longley, M, Lenke, L, Emery, S, Hu, SS. Surgical compared with non-operative treatment for lumbar degenerative spondylolisthesis. Four-year results in the Spine Patient Outcomes Research Trial (SPORT). J Bone Joint Surg (Am) 2009; 91: 1295–304.
10Emery, SE, Bohlman, HH, Bolesta, MJ, Jones, PK. Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy. Two to seventeen year follow-up. J Bone Joint Surg (Am) 1998; 80: 941–51.
11Matsuda, Y, Shibata, T, Oki, S, Kawatani, Y, Mashima, N, Oishi, H. Outcomes of surgical treatment for cervical myelopathy in patients more than 75 years of age. Spine 1999; 24: 529–34.
12Murrey, D, Janssen, M, Delamarter, R, Goldstein, J, Zigler, J, Tay, B, Darden, B. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 2009; 9: 275–86.
13Weinstein, JN, McLain, DF. Primary tumors of the spine. Spine 1987; 12: 843–51.
14Abe, E, Kobayashi, T, Murai, H, Suzuki, T, Chiba, M, Okuyama, K. Total spondylectomy for primary malignant, aggressive benign and solitary metastatic bone tumors of the thoracolumbar spine. J Spinal Disorder 2001; 14: 237–46.
15Constans, JP, De Divittiis, E, Donzelli, R. Spinal metastisis with neurological complications. Review of 600 cases. J Neurosurg 1983; 59: 111–18.
16Tokuhashi, Y, Matsuzaki, H, Toriyama, S, Kawano, H, Ohsaka, S. Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 1990; 15: 1110–13.
17Galibert, P, Deramond, H, Rosat, P, Le Gars, D. Note préliminaire sur le traitement des angiomes vertébraux par vertébroplastie acrylique percutanée. Neurochirurgie 1987; 33: 166–68.
18Bekoff, SM, Maroney, M, Fenton, DC, Matthis, J. An in vitro biomechanical evaluation of bone cements used in percutaneous vertebroplasty. Bone 1999; 25 (suppl 2): 2326.
19Thielen, K, Kallmes, D. Vertebroplasty in multiple myeloma: outcomes in a large patient series. Am J Neuroradiol 2008; 29: 642–48.
20Layton, KF, Theilen, KR, Kallmes, DF. Vertebroplasty, first 1000 levels of a single centre: evaluation of outcomes and complications. Am J Neuroradiol 2007; 28: 683–89.
21Dreinhöfer, KE, Féron, JM, Herrera, A, Hube, R, Johnell, O, Lidgren, L, Miles, K, Panarella, L, Simpson, H, Wallace, WA. Orthopaedic surgeons and fragility fractures: a survey by the Bone and Joint Decade and the International Osteoporosis Foundation. J Bone Joint Surg (Br) 2004; 86: 958–61.
22Buchbinder, R, Osborne, RH, Ebeling, PR, Wark, JD, Mitchell, P, Wriedt, C, Graves, S, Staples, MP, Murphy, B. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361: 557–68.
23Kallmes, DF, Comstock, BA, Heagerty, PJ et al. A randomised trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361: 569–79.
24Clark, W, Lyon, S, Burnes, J. Trials of vertebroplasty for vertebral fractures. N Engl J Med 2009; 361: 2097–100.
25Maynard, A, Jensen, M, Kallmes, DF. Value of bone scan imaging in predicting pain relief from percutaneous vertebroplasty in osteoporotic vertebral fractures. Am J Neuroradiol 2000; 21: 1807–12.
26Klazen, CA, Lohle, PN, de Vries, J, Jansen, FH, Tielbeek, AV, Blonk, MC, Venmans, A, van Rooij, WJ, Schoemaker, MC, Juttmann, JR, Lo, TH, Verhaar, HJ, Van Der Graaf, Y, van Everdingen, KJ, Muller, AF, Elgersma, OE, Halkema, DR, Fransen, H, Janssens, X, Buskens, E, Mali, WP. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2010; 376: 1085–92.



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