Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management.

Abstract

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.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1007/s00586-015-3759-7

Publication Info

Sciubba, Daniel M, Justin K Scheer, Alp Yurter, Justin S Smith, Virginie Lafage, Eric Klineberg, Munish Gupta, Robert Eastlack, et al. (2016). Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 25(8). pp. 2433–2441. 10.1007/s00586-015-3759-7 Retrieved from https://hdl.handle.net/10161/28415.

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