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

Daniel M. Sciubba*, Justin K. Scheer, Alp Yurter, Justin S. Smith, Virginie Lafage, Eric Klineberg, Munish Gupta, Robert Eastlack, Gregory M. Mundis, Themistocles S. Protopsaltis, Donald Blaskiewicz, Han Jo Kim, Tyler Koski, Khaled Kebaish, Christopher I. Shaffrey, Shay Bess, Robert A. Hart, Frank Schwab, Christopher P. Ames

*Corresponding author for this work

Research output: Contribution to journalArticle

35 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2433-2441
Number of pages9
JournalEuropean Spine Journal
Volume25
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • 75 years
  • Adult spinal deformity
  • Complications
  • Elderly
  • HRQOL
  • MCID
  • Non-operative
  • Scoliosis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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  • Cite this

    Sciubba, D. M., Scheer, J. K., Yurter, A., Smith, J. S., Lafage, V., Klineberg, E., Gupta, M., Eastlack, R., Mundis, G. M., Protopsaltis, T. S., Blaskiewicz, D., Kim, H. J., Koski, T., Kebaish, K., Shaffrey, C. I., Bess, S., Hart, R. A., Schwab, F., & Ames, C. P. (2016). Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management. European Spine Journal, 25(8), 2433-2441. https://doi.org/10.1007/s00586-015-3759-7