Impact of Increasing Age on Outcomes of Spinal Fusion in Adult Idiopathic Scoliosis.
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2016-03
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Abstract
Objective
To investigate the role of advancing age on postoperative complications and revision surgery after fusion for scoliosis.Methods
A retrospective, cohort study was performed using the Thomson Reuters MarketScan database, examining patients with adult scoliosis who underwent spinal fusion from 2000 to 2009. Primary outcomes included infection, hemorrhage and pulmonary embolism (PE) within 90 days of surgery, and refusion. The effect of increasing age was estimated using the odds ratio (OR) of complications in a multivariate logistic regression analysis, and a Cox proportional hazard model estimated the hazard ratio of refusion.Results
A total of 8432 patients were included in this study. Overall, the average age was 53.3 years, with 26.90% males and 39% with a Charlson Comorbidity Score of ≥ 1. Most patients had commercial insurance (66.81%), with 26.03% and 7.16% covered by Medicare and Medicaid, respectively. Increasing age (per 5-year increment) was a significant predictor of hemorrhagic complication (OR, 1.06; confidence interval [CI], 1.01-1.11; P = 0.0196), PE (OR, 1.09; CI, 1.03-1.16; P = 0.0031), infection (OR, 1.04; CI, 1.01-1.07; P = 0.0053), and refusion (hazard ratio, 1.07; CI, 1.02-1.13; P = 0.0103).Conclusions
In this study, age was associated with increased risk of hemorrhage, PE, infection, and refusion. With the aging population, the role of patient age on postoperative healing and outcomes deserves deeper investigation after repair of adult idiopathic scoliosis.Type
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Verla, Terence, Owoicho Adogwa, Ulysses Toche, S Harrison Farber, Frank Petraglia, Kelly R Murphy, Steven Thomas, Parastou Fatemi, et al. (2016). Impact of Increasing Age on Outcomes of Spinal Fusion in Adult Idiopathic Scoliosis. World neurosurgery, 87. pp. 591–597. 10.1016/j.wneu.2015.10.061 Retrieved from https://hdl.handle.net/10161/32416.
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Scholars@Duke
Parastou F. Quist
Oren N Gottfried
I specialize in the surgical management of all complex cervical, thoracic, lumbar, or sacral spinal diseases by using minimally invasive as well as standard approaches for arthritis or degenerative disease, deformity, tumors, and trauma. I have a special interest in the treatment of thoracolumbar deformities, occipital-cervical problems, and in helping patients with complex spinal issues from previously unsuccessful surgery or recurrent disease.I listen to my patients to understand their symptoms and experiences so I can provide them with the information and education they need to manage their disease. I make sure my patients understand their treatment options, and what will work best for their individual condition. I treat all my patients with care and concern – just as I would treat my family. I am available to address my patients' concerns before and after surgery. I aim to improve surgical outcomes for my patients and care of all spine patients with active research evaluating clinical and radiological results after spine surgery with multiple prospective databases. I am particularly interested in prevention of spinal deformity, infections, complications, and recurrent spinal disease. Also, I study whether patient specific variables including pelvic/sacral anatomy and sagittal spinal balance predict complications from spine surgery.
Shivanand Lad
Dr. Nandan Lad is a neurosurgeon, scientist, and entrepreneur and Professor and Vice Chair of Innovation for Duke Neurosurgery. He is Director of the Functional & Restorative Neuromodulation Program and the Duke NeuroInnovations Program, a systematic approach to innovation to large unmet clinical needs.
He completed his MD and PhD in Biochemistry at Chicago Medical School and his neurosurgical residency training at Stanford with fellowships in both Surgical Innovation and Functional Neurosurgery.
Neuromodulation; Neurorestoration; Bioengineering; Medical Device Design; Clinical Trials; Data Science; Health Outcomes.
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