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

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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.

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Acknowledgments

Funding for the International Spine Study Group Foundation, through which this study was conducted, is funded through research grants from DePuy Spine and individual donations.

Conflict of interest

None of the authors have a conflict of interest with this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins Hospital, 600 N. Wolfe St, Meyer 5-185, Baltimore, MD, 21287, USA

    Daniel M. Sciubba & Alp Yurter

  2. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Justin K. Scheer & Tyler Koski

  3. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA

    Justin S. Smith & Christopher I. Shaffrey

  4. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA

    Virginie Lafage, Themistocles S. Protopsaltis & Frank Schwab

  5. Department of Orthopaedic Surgery, University of California, Davis, CA, USA

    Eric Klineberg & Munish Gupta

  6. San Diego Center for Spinal Disorders, La Jolla, CA, USA

    Robert Eastlack & Gregory M. Mundis

  7. Neurosurgical Medical Clinic, San Diego, CA, USA

    Donald Blaskiewicz

  8. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA

    Han Jo Kim

  9. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA

    Khaled Kebaish

  10. Rocky Mountain Hospital for Children, Denver, CO, USA

    Shay Bess

  11. Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR, USA

    Robert A. Hart

  12. Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA

    Christopher P. Ames

Authors
  1. Daniel M. Sciubba
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  2. Justin K. Scheer
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  3. Alp Yurter
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  4. Justin S. Smith
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  5. Virginie Lafage
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  6. Eric Klineberg
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  7. Munish Gupta
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  8. Robert Eastlack
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  9. Gregory M. Mundis
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  10. Themistocles S. Protopsaltis
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  11. Donald Blaskiewicz
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  12. Han Jo Kim
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  13. Tyler Koski
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  14. Khaled Kebaish
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  15. Christopher I. Shaffrey
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  16. Shay Bess
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  17. Robert A. Hart
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  18. Frank Schwab
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  19. Christopher P. Ames
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the International Spine Study Group (ISSG)

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Correspondence to Daniel M. Sciubba.

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Sciubba, D.M., Scheer, J.K., Yurter, A. et al. Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management. Eur Spine J 25, 2433–2441 (2016). https://doi.org/10.1007/s00586-015-3759-7

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  • DOI: https://doi.org/10.1007/s00586-015-3759-7

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