RT Journal Article
SR Electronic
T1 Adult Spinal Deformity Over 70 Years of Age: A 2-Year Follow-Up Study
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 336
OP 344
DO 10.14444/6046
VO 13
IS 4
A1 CEM KARABULUT
A1 SELIM AYHAN
A1 SELCEN YUKSEL
A1 VUGAR NABIYEV
A1 ALBA VILA-CASADEMUNT
A1 FERRAN PELLISE
A1 AHMET ALANAY
A1 FRANCISCO JAVIER SANCHEZ PEREZ-GRUESO
A1 FRANK KLEINSTUCK
A1 IBRAHIM OBEID
A1 EMRE ACAROGLU
A1 EUROPEAN SPINE STUDY GROUP
YR 2019
UL https://www.ijssurgery.com/content/13/4/336.abstract
AB Background: Treatment of adult spinal deformity (ASD) in elderly patients remains controversial. The aim of this study was to identify the factors leading to the surgical treatment by comparing the baseline characteristics of operative versus nonoperative patients, to evaluate the safety and efficacy of surgery, and to compare operative and nonoperative management of elderly ASD patients at the end of the 2-year follow-up period.Methods: Retrospective review of a multicenter, prospective ASD database was performed. Patients over 70 years of age with ASD who were scheduled to undergo surgical treatment and who were treated and/or followed without surgical intervention participated in the study. Demographic, clinical, surgical, and radiological characteristics and health-related quality-of-life (HRQOL) (Core Outcome Measures Index [COMI], Oswestry Disability Index [ODI], Short-Form-36 Mental Component Summary [SF-36 MCS], Short-Form-36 Physical Component Summary [SF36-PCS], and Scoliosis Research Society-22 [SRS-22]) parameters of such group of patients were evaluated pre- and posttreatment.Results: A total 90 patients (females: 71, males: 29; operative: 61, nonoperative: 29) made up the study group. The comparison between the operative and the nonoperative groups at baseline showed statistical significance for all the HRQOL parameters and the major coronal Cobb angle (P < .05). The calculated optimal cutoff values to diverge operative and nonoperative groups for COMI, ODI, SF-36 PCS, and SRS-22 were 5.7, 37.0, 37.5, and 3.2, respectively (P < .05). All operative patients were treated with posterior surgery. Overall, 135 complications (71 major, 64 minor) and 1 death were observed. Surgically treated patients were found to be improved both clinically and in HRQOL parameters 2 years after surgery for all HRQOL parameters except SF-36 MCS, even in the presence of complications (P < .05), while nonoperative patients have not changed or deteriorated at the end of 2 years.Conclusions: Despite a relatively high incidence of complications, the likelihood of achieving a clinically significant and relevant HRQOL improvement was superior for patients who were treated surgically in the present population.