Chinese society is progressively aging, and more and more patients suffer from spinal diseases in advanced age patients (>75 years). Surgery is still the most effective solution for patients who have failed conservative treatment or who present with progressively worsening symptoms. Excluding surgical and anesthetic technical failures, the key factors affecting the incidence of postoperative complications are the stress response to surgery and the increased demands on organ function after surgery. Late old patients generally have a poor ability to withstand surgical shock, the implementation of enhanced recovery after surgery (ERAS) to reduce surgical stress response is more important for late old patients undergoing spinal surgery. Specific measures to familiarize more spinal surgeons with older spinal ERAS. On the basis of evidence-based medicine, experts from the Geriatric Group of Orthopaedic Branch of Beijing Medical Association, Geriatric Anesthesiology Group of Anesthesiology Branch of Chinese Medical Association reached the following expert consensus through multiple discussions and votes based on the existing clinical experience and published relevant data, for the reference of academic colleagues.