Radiographic and patient reported outcomes in adult spinal deformity revision surgery

Purpose: To determine the differences in radiographic and health-related quality of life outcomes of patients who were either younger or older than 65 years of age and underwent a revision adult spinal deformity surgery. Methods: This is a single center study that retrospectively evaluated the functional scores and radiographic parameters in patients who underwent a revision adult spinal deformity surgery between January 2015 and June 2020. Radiographic measurements and HRQOLs were measured pre-operatively, post-operatively and at final follow up. A total of 103 patients met inclusion criteria. These were divided into 2 groups, under 65 years (n = 60 patients), and over 65 years of age (n = 43 patients). Results: Analysis of the radiographic parameters at the various time points demonstrated statistically significant differences between preoperative and early postoperative parameters, except for thoracic kyphosis TK(p = 0.018). In both group, there was statistically significant improvement in PI-LL difference and LL. Comparison of the early postoperative follow-up data and last follow-up data showed statistically significant difference for PT (p = 0.013), TK (p = 0.012) and SVA (p = 0.015). When analyzing HRQOLs at the various time points, there was a statistically significant improvement in both groups between preoperative and final follow up scores and there was no significant difference between two groups. Complications in patients over 65 years of age occurred in 10/43(23%). In the under 65 group, complications occurred in 16/60 (27%). Conclusion: This study demonstrated similar improvement in radiographic parameters and functional outcome scores in patients undergoing revision ASD surgery stratified according to age.