Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology

<h3>Background</h3> Full endoscopic spine surgery (FESS) champions a rapid recovery and a low rate of overall complications. However, its efficacy in geriatric patients that might yield additional benefits from minimized invasiveness remains underexplored. <h3>Methods</h3> A multi-institutional prospective cohort study was conducted involving patients undergoing elective lumbar FESS. Participants were categorized into nongeriatric (18–69 years old) and geriatric (≥70 years old) groups. Studied variables included demographics, medical comorbidities, operative details, visual analog scale (VAS) for back and leg pain, and Oswestry Disability Index (ODI). A mobile application was leveraged to collect real-time data pre- and postoperatively. <h3>Results</h3> One hundred and sixty-four patients were included and divided into nongeriatric (<i>N</i> = 125) and geriatric (<i>N</i> = 39) cohorts. No group differences were observed between sex (<i>P</i> = 0.404), body mass index (<i>P</i> = 0.372), procedure duration (<i>P</i> = 0.350), or blood loss (<i>P</i> = 0.384). Nongeriatric patients received discectomy more frequently (<i>P</i> &lt; 0.001), while older patients underwent more decompressive procedures (<i>P</i> &lt; 0.001). Characterization of pain and functional outcome revealed that nongeriatric and geriatric patients follow a similar recovery trajectory and both appreciate significant improvements from baseline to 3 months postoperatively (<i>P</i> &lt; 0.001 for VAS back, VAS leg, and ODI). There were no differences in the rate of improvement between age groups at any time point (<i>P</i> &gt; 0.05 for VAS back, VAS leg, and ODI). <h3>Conclusions</h3> FESS significantly improves pain and function in both geriatric and nongeriatric adults with degenerative lumbar conditions, with no difference in the degree of improvement between groups. <h3>Clinical Relevance</h3> These findings underscore the efficacy of FESS as a minimally invasive surgical option for elderly patients. Mobile application technology is useful for collecting patient-reported data in spine surgery clinical research. <h3>Level of Evidence</h3> 3.