How Old is Too Old for Surgery?

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Is age a barrier to spine surgery? When are you too old for surgery? Should you try to have surgery done while you are younger? Here's a straight answer to this common patient question from leading neurosurgeon Mark R. McLaughlin, MD

Generally, age is not a factor in my surgical decision making. Obviously, people who are who are very old or have multiple medical problems, that's something we're gonna be more careful about.

But anesthesia is generally very safe where if if you're an older person and we're considering surgery, we're gonna get clearances from the heart doctor and the medical doctor and make sure that you're safe to have anesthesia. Sometimes we need to get a, clearance from a pulmonary doctor. But generally, anesthesia is safe, and I'll consider patients, surgical candidates in their seventies, eighties, and sometimes even nineties for spine disease because, if they're the right candidate and they have a complaint that fits with their their MRI scan, they're most likely gonna get better.

And it's like you said, it's one of those things where age produces degenerative arthritis and can cause pinched nerves. And so, you know, do we sentence that person to the rest of their life being in pain, because they're older? No.

They're they're they're a potential candidate for surgery. I've often heard other people say, well, I wanna get my surgery done while I'm young because I don't wanna have it later when I'm when I'm older. And I say, no. You you have surgery when it's time to have surgery, not before, not after.

You're not thinking about the future to have surgery. You have surgery when you need to have surgery. 
And the indications for surgery are intractable pain, having more bad days than good days, having a scan that shows a lesion that we can fix that's focal. In other words, it's a single lesion. It's not a multilevel, problem.

The chances for multilevel surgery, the success rate does not continue to go up. It's better when there's a focal lesion and when you've tried all conservative treatments. Those are good indications for surgery. And and, yes, we're gonna consider your age. Yes, we're gonna consider your medical conditions.

But, people can undergo surgery in their eighties and nineties and still do very well in selected appropriately chosen surgeries.