Is it good to undertake neurosurgery in a 71-year-old?

Question

Hello doctor,

I need help for my aunt. She is 71 years old, 62 inches, and 97 pounds. She has constant pain and difficulty in getting up, even in standing for long periods. She has little control over her legs, takes fewer and fewer steps at a time, and almost drags her feet. She has already undergone:

In 2017, for spondylosis with myelopathy, a microdiscectomy was performed at C4-C5 and C5-C6, with the removal of osteophytes and anterior interbody arthrodesis.
In 2018, for disc degeneration and herniation, and spinal stenosis, instrumented posterolateral arthrodesis at L4-S1, discectomy, and decompression at L4-L5.
In 2025, marked left nSPE axonal damage with distal recruitment deficit was shown in this region, in a context of probable polyradicular damage at L4-L5-S1—no signs of ongoing denervation.
Lumbosacral MRI report from 2025: S-shaped scoliosis, results of arthrodesis with transpedicular screws between L4 and S1. Thin and degenerated intervertebral discs. Intraforaminal herniation at L2-L3 on the left; wide-area herniation at L3-L4. Reduced spinal canal diameters.
In 2025, an MRI scan, a Z-score of -1.3, and low BMD.

The neurosurgeon now says that the vertebrae he operated on previously are free, and the major problem is not the herniations, but the severe scoliosis. He does not dare to operate, but recommends continuing the therapy with painkillers, a V-type brace for five to six hours a day, and constant lumbar spine physiotherapy.

My aunt is afraid of losing her independence. She lives as if she were 90 years old. She has difficulty moving. I am not asking for a response, but I would like to know if anyone, in complex cases like this, has dared to perform microsurgery again, and if so, how. Or if it is pointless to take my aunt to another neurosurgeon in the first place. Thank you so much to anyone who can answer.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

It is completely understandable to feel worried and frustrated watching your aunt struggle with such severe pain and loss of mobility after everything she has already been through.

From what you describe, your aunt’s condition is very complex, involving multiple spinal surgeries, significant scoliosis, degenerative disc disease, and nerve damage.

At her age, the risks of another spinal surgery are higher, especially given her low bone density and frail build, which make healing and stability more difficult. This is likely why her current neurosurgeon is being cautious and prefers conservative management with pain control, physiotherapy, and the supportive brace.

However, getting a second opinion from another experienced spinal or orthopedic neurosurgeon is not pointless.

It may provide clarity on whether any minimally invasive or targeted microsurgical procedures could relieve nerve compression or stabilize her spine further without major risks. Some specialized centers do perform revision or corrective spinal surgeries in elderly patients, but these are very carefully selected cases where the benefits outweigh the risks.

In the meantime, focusing on maintaining muscle strength, balance, and bone health through gentle physiotherapy, nutrition rich in calcium and vitamin D, and possibly osteoporosis treatment can help slow progression.

She must not lose hope, as even small improvements in movement and pain relief can greatly enhance her independence and quality of life. You are doing the right thing by advocating for her and seeking the best possible care.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.