Abstract
BACKGROUND: Minimally invasive posterior lumbar interbody fusion (MIS-PLIF) is commonly performed to treat degenerative lumbar spinal conditions. Patients of advanced age often present with multiple comorbidities and reduced physiological reserves, influencing surgical risks and recovery. The growing aging population has led to a rising demand for care for older adults, posing significant challenges for health care systems worldwide. OBJECTIVE: This study aimed to identify the associations between different age groups and MIS-PLIF outcomes. METHODS: This study retrospectively analyzed data from the United States Nationwide Inpatient Sample collected between 2016 and 2020. Patients aged ≥60 years who underwent MIS-PLIF were eligible for inclusion in this study. Patients were categorized into age groups (60-69, 70-79, and ≥80 y). Logistic and linear regressions were used to determine the associations between the study variables and outcomes, including in-hospital mortality, complications, nonroutine discharge, and length of stay. RESULTS: A total of 785 patients aged ≥60 (mean age 69.4, SD 0.2) years who underwent MIS-PLIF were included in the analysis, and 18.7% (147/785) experienced at least one complication. After adjustment, compared with patients aged 60 to 69 years, the risk of nonroutine discharge was significantly increased in patients aged 70 to 79 years (adjusted odds ratio 2.33, 95% CI 1.57-3.46; P<.001) and ≥80 years (adjusted odds ratio 4.79, 95% CI 2.64-8.67; P<.001). No significant differences in the risk of complications or length of hospital stay were observed across the age groups. CONCLUSIONS: In older patients undergoing MIS-PLIF, advanced age is an independent predictor of nonroutine discharge. Furthermore, our findings suggest that age alone is not an independent risk factor for complications or extended hospital stays among older patients. These findings underscore that MIS-PLIF is a viable option for older patients, for whom extra attention may still be needed for postoperative care. Implementing age-stratified management for older patients undergoing MIS-PLIF may have important clinical policy implications.