Perioperative Complications of the Occipitocervical Fixation Surgery for Cervical Trauma in Patients Aged Over 80 Years.

Authors

Norihiro Isogai, Haruki Funao, Mitsuru Yagi, Noriaki Yokogawa, Hiroaki Nakashima, Toru Funayama, Shota Ikegami, Kota Watanabe, Atsushi Yunde, Nobuyuki Suzuki, Hidenori Suzuki, Gen Inoue, Hideaki Nakajima, Tomohiko Hasegawa, Yoshinori Terashima, Ko Hashimoto, Hiroshi Uei, Kenichiro Kakutani, Katsuhito Kiyasu, Hiroyuki Tominaga, Masayuki Ishihara, Takashi Kaito, Satoshi Kato

Published in

Spine surgery and related research. Volume 10. Issue 5. Pages 660-665. Sep 27, 2026. Epub Apr 08, 2026.

Abstract

Although severe perioperative complications have been reported after occipitocervical fixation surgery for cervical trauma, no studies have specifically evaluated these complications in patients aged over 80 years. This study aimed to assess perioperative complications following occipitocervical fixation surgery for cervical trauma in patients older than 80 years.
Among the 1,512 patients with cervical injury treated between 2010 and 2020, 41 patients aged ≥65 years who underwent occipitocervical fixation surgery were enrolled at 77 institutions in Japan. Patients were classified into a young-old group (65-79 years, n=21) and an old-old group (≥80 years, n=20). Demographic and surgical data, diagnosis, comorbidities, and perioperative complications were compared between the two groups.
The young-old group included eight atlas fractures and 16 axis fractures, while the old-old group included seven atlas fractures and 15 axis fractures. Perioperative complications occurred in 11 (52%) cases in the young-old group and in four cases (20%) in the old-old group. Reported complications included delirium, dysphagia, pneumonia, implant failure, worsening neurological pain, respiratory disorder, urinary tract infection, diverticular bleeding, cerebral infarction, deep vein thrombosis, and death.
Although there were several selection biases, including trauma severity and surgical indication, advanced age of over 80 years alone does not necessarily lead to a markedly increased risk of perioperative complications following occipitocervical fixation surgery for traumatic cervical spine injuries.
Level III.

PMID:
42893159
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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