Expert consensus on preoperative assessment and management for older patients with degenerative spinal diseases

Abstract

Population aging has drastically increased the prevalence of degenerative spinal diseases in Chinese patients aged 65 years and older, who frequently carry multiple systemic comorbidities that significantly elevate perioperative surgical risks. Standardized preoperative evaluation and individualized perioperative management are urgently needed to improve spinal surgery safety for this vulnerable population. This expert consensus was formulated by a multidisciplinary panel of spinal surgeons, geriatricians, cardiologists, anesthesiologists and respiratory specialists, using a modified Delphi process based on domestic and international clinical evidence, aiming to unify preoperative assessment criteria and optimize comprehensive perioperative strategies for older patients with degenerative spinal disorders. The consensus systematically elaborates standardized assessment and management protocols covering ten core clinical issues: coronary heart disease and antiplatelet therapy after percutaneous coronary intervention (PCI), perioperative anticoagulation for atrial fibrillation, hypertension control, glycemic regulation for diabetes, cardiopulmonary function evaluation, cerebrovascular disease screening, nutritional risk intervention, preoperative cognitive function assessment, and frailty. This consensus provides a standardized, operable clinical framework for perioperative risk control in older spinal surgery patients, reduces perioperative major adverse events, and facilitates safer, more individualized perioperative management for aging patients with degenerative spinal diseases.

Keywords

aged / spinal Diseases / perioperative care / risk assessment / consensus

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The Author(s) 2026.

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