chapter  9
13 Pages

Neurosurgery: Spine surgery

WithM.V.S. Satya Prakash, M. Senthilnathan

With the increase in the amount of geriatric population in combination with improvements in modern medicine, the number of geriatric patients undergoing surgery is also increasing. Geriatric patients have increased risk for falls because of disturbances in the autonomic system due to polypharmacy, peripheral neuropathy, and autonomic dysregulation. The elderly are more prone to malignancies, which may also occur in skeletal system or may metastasize to the spine. Geriatric patients are frequently suffering from multiple diseases and might be on polypharmacy. Changes in the structure of collagen in geriatric patients can lead to stiffness of the joints, which necessitates thorough assessment of the airway for ease of intubation. A medication review must be done and the drugs that are necessary should be continued on the night before the surgery and the morning of surgery; the drugs that need to be skipped should be advised accordingly during the preoperative visit.