TY - JOUR
T1 - Patients with spinal deformity over the age of 75
T2 - a retrospective analysis of operative versus non-operative management
AU - Sciubba, Daniel M.
AU - Scheer, Justin K.
AU - Yurter, Alp
AU - Smith, Justin S.
AU - Lafage, Virginie
AU - Klineberg, Eric
AU - Gupta, Munish
AU - Eastlack, Robert
AU - Mundis, Gregory M.
AU - Protopsaltis, Themistocles S.
AU - Blaskiewicz, Donald
AU - Kim, Han Jo
AU - Koski, Tyler
AU - Kebaish, Khaled
AU - Shaffrey, Christopher I.
AU - Bess, Shay
AU - Hart, Robert A.
AU - Schwab, Frank
AU - Ames, Christopher P.
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Purpose: The goal of the present study was to compare the outcomes of operative and non-operative patients with adult spinal deformity (ASD) over 75 years of age. Methods: A retrospective review of a multicenter prospective adult spinal deformity database was conducted examining patients with ASD over the age of 75 years. Demographics, comorbidities, operation-related variables, complications, radiographs, and Health-related quality of life (HRQOL) measures collected included Oswestry Disability Index, Short Form-36, and Scoliosis Research Society-22 preoperatively, and at 1 and 2 years later. Minimum clinically important difference (MCID) was calculated and also compared. Results: 27 patients (12 operative, 15 non-operative) were studied. There were no significant differences (p > 0.05) between operative and non-operative patients for age, body mass-index, and comorbidities, but operative patients had worse baseline HRQOL than non-operative patients. Operative patients had a significant improvement in radiographic parameters in 2-year HRQOL, whereas non-operative patients did not (p > 0.05). Operative patients were significantly more likely to reach MCID (range 41.7–81.8 vs. 0–33.3 %, p < 0.05). In the surgical group, 9 (75 %) patients had at least 1 complication (24 total complications). Conclusions: In the largest series to date comparing operative and non-operative management of adult spinal deformity in elderly patients greater than 75 years of age, reconstructive surgery provides significant improvements in pain and disability over a 2-year period. Furthermore, operative patients were more likely to reach MCID than non-operative patients. When counseling elderly patients with ASD, such data may be helpful in the decision-making process regarding treatment.
AB - Purpose: The goal of the present study was to compare the outcomes of operative and non-operative patients with adult spinal deformity (ASD) over 75 years of age. Methods: A retrospective review of a multicenter prospective adult spinal deformity database was conducted examining patients with ASD over the age of 75 years. Demographics, comorbidities, operation-related variables, complications, radiographs, and Health-related quality of life (HRQOL) measures collected included Oswestry Disability Index, Short Form-36, and Scoliosis Research Society-22 preoperatively, and at 1 and 2 years later. Minimum clinically important difference (MCID) was calculated and also compared. Results: 27 patients (12 operative, 15 non-operative) were studied. There were no significant differences (p > 0.05) between operative and non-operative patients for age, body mass-index, and comorbidities, but operative patients had worse baseline HRQOL than non-operative patients. Operative patients had a significant improvement in radiographic parameters in 2-year HRQOL, whereas non-operative patients did not (p > 0.05). Operative patients were significantly more likely to reach MCID (range 41.7–81.8 vs. 0–33.3 %, p < 0.05). In the surgical group, 9 (75 %) patients had at least 1 complication (24 total complications). Conclusions: In the largest series to date comparing operative and non-operative management of adult spinal deformity in elderly patients greater than 75 years of age, reconstructive surgery provides significant improvements in pain and disability over a 2-year period. Furthermore, operative patients were more likely to reach MCID than non-operative patients. When counseling elderly patients with ASD, such data may be helpful in the decision-making process regarding treatment.
KW - 75 years
KW - Adult spinal deformity
KW - Complications
KW - Elderly
KW - HRQOL
KW - MCID
KW - Non-operative
KW - Scoliosis
UR - http://www.scopus.com/inward/record.url?scp=84922423998&partnerID=8YFLogxK
U2 - 10.1007/s00586-015-3759-7
DO - 10.1007/s00586-015-3759-7
M3 - Article
C2 - 25657104
AN - SCOPUS:84922423998
SN - 0940-6719
VL - 25
SP - 2433
EP - 2441
JO - European Spine Journal
JF - European Spine Journal
IS - 8
ER -