Introduction: Aging increases susceptibility to postoperative spinal infections through immunosenescence, microvascular dysfunction, and systemic comorbidity. Despite rising surgical volumes in older adults, the independent contribution of advanced age to infection risk remains debated. This study evaluates the pathological impact of aging on the risk of postoperative spinal infections to clarify its specific role in clinical outcomes.

Material and methods: This descriptive cross-sectional study, conducted at Shahid Madani Hospital, investigated the pathological impact of aging on postoperative spinal infections. Based on Cochran’s formula, 111 participants were selected via convenience sampling. Clinical records were analyzed to evaluate demographic, surgical, and outcome variables. Associations between age and infection risk were assessed using appropriate statistical tests, with full ethical approval obtained from Tabriz University of Medical Sciences.

Results: Postoperative spinal infection incidence significantly increased with age, rising from 6.7% to 25.0% (P for trend=0.037). Older patients exhibited higher systemic comorbidities and surgical complexity. Multivariable analysis identified advancing age as an independent infection predictor (adjusted OR=1.68, 95% CI:1.12–2.52; P=0.012), alongside prolonged operative duration (adjusted OR=2.80; P=0.014) and diabetes (adjusted OR=2.45; P=0.031), confirming the biological burden of senescence.

Conclusion: Advanced age serves as an independent risk factor for postoperative spinal infections, driven by the convergence of immunosenescence, systemic comorbidities, and decreased physiological reserve. Surgeons must implement targeted preoperative optimization and meticulous intraoperative techniques to mitigate risks in elderly populations.