• Shane Zaw, Lin Sen, Joshua Zhi En Koh, Lilian Ow, Dinesh Shree Kumar, Hong Lee Terry Teo, Zhihong Chew, Ree Yi Koh, Zhen Yang, Andy Kuei Siong Yeo, and Lester Lee.
• Division of Neurosurgery, Changi General Hospital, Singapore.
• Neurosurgery. 2025 Jan 29.

Background And ObjectiveThe global average life expectancy has been increasing steadily as the quality of healthcare continues to improve. However, there is a paucity of data looking at surgical fixation of thoracolumbar spine fractures in patients ≥80 years (super-elderly). Aim of this study is to look at whether there is higher rate of complications from surgical fixation of thoracolumbar fractures in this group of patients.MethodsWe performed a retrospective study of patients who underwent surgical fixation of thoracolumbar spine fractures from 2019 to 2023. Patients were dichotomized into those who were 80 years old and above (super-elderly) and those younger than 80 years (control). Variables include sex, age, Charleston comorbidity index, presence of osteoporosis, length of hospital stay, complications, 6- and 12-months' implant status, and mortality. Incidence of revision surgery, rate of implant loosening, and mortality between the 2 groups were analyzed.ResultsTotal of 108 patients were included, 43 patients in the super-elderly group and 65 in the control group. Despite the super-elderly having a higher rate of osteoporosis and higher proportion of patients with severe comorbidities (P < .0001), there was no significant difference in the rate of implant loosening at 12 months' follow-up (P = .467) or all-cause mortality (P = .158). There were no significant differences between the 2 groups regarding revision surgery (P = .923) needed either.ConclusionThe super-elderly had a higher incidence of osteoporosis and worse comorbidities, but there was no significant difference regarding implant complications, revision surgery required, or all-cause mortality. Hence, surgical fixation of thoracolumbar spine fractures in people older than 80 years should be considered despite their advanced age.Copyright © Congress of Neurological Surgeons 2025. All rights reserved.

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