Spine procedures are on the increase globally, predominantly due people living to older ages of 65 years and above. This global trend is also reflected in Nigeria and due availabilities of professionals and facilities to manage these patients. A large majority of patients that present for spine procedures are elderly, and are likely to have several comorbidities, hence a multi-disciplinary approach cannot be over emphasised. Different professional team to manage and prepare them for surgery, as well as competent anaesthetist team who understands the pathophysiology of elderly patients to manage them perioperative. This case report highlights the importance of team approach to successful management of an elderly patient with numerous challenges.