Outcome of Prospective Evaluation of Elderly Deformity Surgery (PEEDS): A Multicenter International Study on Patients Over 60 years of Age Undergoing Multilevel Spinal Deformity Corrections.

Abstract

DesignProspective multicenter observational study.ObjectivesSpinal deformity has a significant impact on health in elderly patients. The appropriate use of multilevel fusion surgery in elderly patients requires information regarding the expected outcomes and complications.MethodsPatients ≥60 years undergoing ≥5 levels of spinal fusion from 12 international centers were enrolled and followed up to 5 years post-operatively.Results219 of 229 enrolled patients met the inclusion criteria. The mean age was 67.5 (range 60-83) years with 80.4% female patients. The mean changes (95% CI) of the subtotal and total SRS-22r scores from baseline to 5-year follow up were 0.88 (0.76;1.00) and 0.90 (0.78;1.02), respectively (P < 0.001). Comparable improvements were observed in the Oswestry Disability Index, Numeric Rating Scale and EQ-5D with maximum improvement noted at 1 year and maintained at the 2- and 5-year follow-ups. Overall, there were 244 adverse events reported in 124 patients during the 2-year follow-up period, and further 25 adverse events reported in 20 patients between 2 and 5 years.ConclusionMultilevel reconstructive surgery in elderly patients with spinal deformity is associated with significant improvement in self-reported outcomes despite a relatively high rate of adverse events. The results of this study provide important information regarding the expected risks and benefits of surgery in these patients, empowering patients and physicians to make informed choices regarding care.