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. 2020 Dec;8(6):1353-1359.
doi: 10.1007/s43390-020-00169-3. Epub 2020 Jul 21.

Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older?

Zachary R Lovato  1   2 , David G Deckey  3 , Andrew S Chung  4 , Dennis G Crandall  1   2   4   5 , Jan Revella  2 , Michael S Chang  1   2   4   5
Affiliations

Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older?

Zachary R Lovato et al. Spine Deform. 2020 Dec.

Abstract

Study design: Retrospective study of a prospectively collected database at one center.

Objectives: Assess the outcomes and complications of adult spinal deformity (ASD) surgery in patients that are 75 years and older compared with patients of 65-75 years of age. With increasing amounts of ASD surgery being performed on elderly patients, it is important to assess how age plays a factor in corrective reconstruction surgery.

Methods: Inclusion criteria for the study were all patients ≥ 65 years of age that underwent thoracolumbar deformity correction involving ≥ four levels at a single institution by two surgeons. Patients were divided based on age into 65-74.9 or ≥ 75 groups. Radiographic parameters were measured preoperatively, postoperatively, and at 2 years. The Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were collected preoperatively, at 1 year, and 2 years. Comorbidities included were based around the Charlson Comorbidity Index (CCI) and compared to the incidence of complications and need for further surgery.

Results: Both age groups had improvements in their radiographic parameters postoperatively which was maintained at 2 years. Comparing the different age groups with similar comorbidity burden in regard to complications and need for additional surgery yielded no statistically significant difference between groups. Both groups had comparable decreases in NRS and increases in ODI at 2 years.

Conclusions: Analysis of our study population indicates that there is no difference between the outcomes and complications of deformity surgery in patients 75 years and older when compared to a younger elderly population. It also does not appear that a ≥ 3 comorbidity burden has a significant impact on the complications or need for additional surgery in our elderly spinal deformity surgery population.

Level of evidence: Level IV.

Keywords: Age; Comorbidities; Complications; Geriatrics; Outcomes; Radiographic parameters.

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