1075 Comparison of Pain and Functional Outcomes Among Geriatric and Non-Geriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology: Analysis of a Multi-Center Prospective Cohort

INTRODUCTION: Degenerative spinal conditions requiring surgical intervention are increasing due to an aging global population. Compared to traditional open surgery, full endoscopic spine surgery (FESS) champions a rapid recovery. However, its efficacy in elderly patients that might yield additional benefits from minimized invasiveness remains underexplored. METHODS: A multi-institutional prospective observational cohort study was conducted involving patients undergoing elective lumbar FESS. Participants were categorized into non-geriatric (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 ipsilateral leg pain, and Oswestry Disability Index (ODI). A mobile application was leveraged to collect real-time data preoperatively and postoperatively. RESULTS: 164 patients were included and divided into non-geriatric (N=125) and geriatric (N=39) cohorts. No group differences were observed between sex (p=0.404), BMI (p=0.372), procedure duration (p=0.350), or blood loss (p=0.384). Non-geriatric patients received discectomy more frequently (p<0.001), while older patients underwent more decompressive procedures (p<0.001). Characterization of pain and functional outcome revealed that non-geriatric and geriatric patients follow a similar recovery trajectory and both appreciate significant improvements from baseline to three months postoperatively (p<0.001 for VAS back, VAS leg, ODI). There were no differences in rate of improvement between age groups at any time point (p>0.05 for VAS back, VAS leg, ODI). Lastly, 78% and 82% of non-geriatric and geriatric patients, respectively, had perceived their surgical outcome as ‘good’ at three months, with the remaining deeming it as ‘poor’ (p=0.623). CONCLUSIONS: FESS significantly improves pain and function in both geriatric and non-geriatric adults with degenerative lumbar conditions, with no difference in the degree of improvement between groups. These findings underscore the efficacy of FESS as a minimally invasive surgical option for elderly patients.