Trends and epidemiology of spine fractures in the super-elderly population in the United States

Introduction: Spine fractures occur commonly in the geriatric population. Super-elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of spine fractures in the super-elderly population is incompletely described in the literature. MATERIALS AND METHODS: This descriptive epidemiology study used the National Electronic Injury Surveillance System to examine the incidence and recent trends of spine fractures occurring among super-elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates. Results: An estimated n = 385,375 super-elderly patients sustained spine fractures over the 10-year study period for an overall IR of 31.5 per 10,000 person-years at-risk. Lumbar fractures (IR = 16.3) were the most common, followed by thoracic (IR = 9.4) and cervical (IR = 6.9) fractures. Incidence was significantly higher in super-elderly females (IR = 35.6) than in males (IR = 24.8). Incidence was significantly higher in nonagenarians (IR = 50.7) and centenarians (IR = 42.6) than in octogenarians (IR = 26.8). Accounting for population growth yielded a significantly increasing incidence over the study period from 20.8 in 2011 to 40.3 in 2020 (AAPC = 8, P < 0.0001). Conclusions: This study suggests that the annual incidence of spine fractures in the oldest cohort of patients in the US (80 + years of age) increased significantly during the recent decade from 2011 to 2020. Increased IRs highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.