A review of comorbidities and spinal surgery

Abstract

As the population ages, greater numbers of elderly patients will be considered for spinal surgery for spinal stenosis and complex primary and revision reconstructions. The age-related medical comorbidities impact not only on the decision to undertake a procedure but also impact the magnitude of the procedure. The surgeon must understand aging and medical comorbidities to facilitate preoperative decision-making and postoperative care. A review of the more common age-related pathophysiologic changes to the cardiovascular, pulmonary, and central nervous systems is undertaken. General recommendations for perioperative treatment are made relative to published series regarding the impact of age and medical comorbidities on short- and long-term outcomes.