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. 2019 Apr 10;8(4):483.
doi: 10.3390/jcm8040483.

Long Term Outcomes and Effects of Surgery on Degenerative Spinal Deformity: A 14-Year National Cohort Study

Yu-Chun Chen  1   2   3   4 , Wen-Cheng Huang  5   6 , Hsuan-Kan Chang  7   8   9 , Jiing-Feng Lirng  10   11 , Jau-Ching Wu  12   13
Affiliations

Long Term Outcomes and Effects of Surgery on Degenerative Spinal Deformity: A 14-Year National Cohort Study

Yu-Chun Chen et al. J Clin Med. .

Abstract

Degenerative spinal deformity (DSD) has become a prevalent cause of disability and pain among the aging population worldwide. Though surgery has emerged as a promising option for DSD, the natural course, outcomes, and effects of surgery on DSD have remained elusive. This cohort study used a national database to comprehensively follow up patients of DSD for all-cause mortality, respiratory problems, and hip fracture-related hospitalizations. All patients were grouped into an operation or a non-operation group for comparison. An adjustment of demographics, comorbidities, and propensity-score matching was conducted to ameliorate confounders. A Cox regression hazard ratio (HR) model and Kaplan-Meier analysis were also applied. The study comprised 21,810 DSD patients, including 12,544 of the operation group and 9266 of the non-operation group. During the 14 years (total 109,591.2 person-years) of follow-up, the operation group had lower mortality (crude hazard ratio = 0.40), lower respiratory problems (cHR = 0.45), and lower hip fractures (cHR = 0.63) than the non-operation group (all p < 0.001). After adjustment, the risks for mortality and respiratory problems remained lower (adjusted HR = 0.60 and 0.65, both p < 0.001) in the operation than the non-operation group, while hip fractures were indifferent (aHR = 1.08, p > 0.05). Therefore, surgery for DSD is invaluable since it could reduce the risks of mortality and of hospitalization for respiratory problems.

Keywords: Degenerative Spinal Deformity (DSD); hip fractures; mortality; respiratory problems; surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of data processing for outcomes of a cohort with degenerative spinal deformity (DSD), with a subgroup analysis of patients from both groups and who were matched with propensity scores. DSD patients in Taiwan, 2000–2013 (n = 26,322).
Figure 2
Figure 2
Cumulative incidences of all-cause mortality (a,d), respiratory problems (b,e), and hip fractures (c,f) during the 14 years of follow-up of both the non-operation and operation groups.
Figure 2
Figure 2
Cumulative incidences of all-cause mortality (a,d), respiratory problems (b,e), and hip fractures (c,f) during the 14 years of follow-up of both the non-operation and operation groups.
See this image and copyright information in PMC

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