Retrospective study of a prospectively collected database at one center.
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.
Summary of background data
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.
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.
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.
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
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This study was self-funded. No corporate or industry funds were received in support of this work.
Conflict of interest
MSC reports consulting fees from Orthofix, Stryker, Depuy, SpineWave, and BK; DGC reports royalties from Spinewave and Medtronic, stock ownership in Handel, and consulting fees from U&I and SpineWave; all other others have no relevant financial disclosures.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Sonoran Spine Center and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. IRB approval was granted at Sonoran Spine Research and Education Foundation.
Informed consent was obtained from patients prior to inclusion in this study.
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Lovato, Z.R., Deckey, D.G., Chung, A.S. et al. Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older?. Spine Deform (2020). https://doi.org/10.1007/s43390-020-00169-3
- Radiographic parameters