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Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age

STUDY DESIGN: Retrospective review of a prospective, multicenter database. OBJECTIVE: The purpose of this study was to assess whether elderly patients undergoing scoliosis surgery had an incidence of complications and improvement in outcome measures comparable with younger patients. SUMMARY OF BACKGROUND DATA: Complications increase with age for adults undergoing scoliosis surgery, but whether this impacts the outcomes of older patients is largely unknown. METHODS: This is a retrospective review of a prospective, multicenter spinal deformity database. Patients complete the Oswestry Disability Index (ODI), SF-12, Scoliosis Research Society-22 (SRS-22), and numerical rating scale (NRS; 0-10) for back and leg pain. Inclusion criteria included age 25 to 85 years, scoliosis (Cobb >/= 30 degrees ), plan for scoliosis surgery, and 2-year follow-up. RESULTS: Two hundred six of 453 patients (45%) completed 2-year follow-up, which is distributed among age groups as follows: 25 to 44 (n = 47), 45 to 64 (n = 121), and 65 to 85 (n = 38) years. The percentages of patients with 2-year follow-up by age group were as follows: 25 to 44 (45%), 45 to 64 (48%), and 65 to 85 (40%) years. These groups had perioperative complication rates of 17%, 42%, and 71%, respectively (P < 0.001). At baseline, elderly patients (65-85 years) had greater disability (ODI, P = 0.001), worse health status (SF-12 physical component score (PCS), P < 0.001), and more severe back and leg pain (NRS, P = 0.04 and P = 0.01, respectively) than younger patients. Mean SRS-22 did not differ significantly at baseline. Within each age group, at 2-year follow-up there were significant improvements in ODI (P Keywords : Adult,adverse effects,Age Factors,Aged,Aged,80 and over,analysis,Back,Back Pain,complications,Databases,Factual,Decompression,Surgical,Disability Evaluation,etiology,Female,Health Status,Humans,Incidence,Leg,Male,methods,Middle Aged,Neurosurgery,Osteotomy,Pain,Patients,physiopathology,Postoperative Complications,Prospective Studies,rehabilitation,Retrospective Studies,Risk,Risk Assessment,Scoliosis,Severity of Illness Index,Spinal Fusion,surgery,Treatment Outcome,trends,Universities,, Assessment,Surgery,Adult, back pain flare up

Date of Publication : 2011 May 1

Authors : Smith JS;Shaffrey CI;Glassman SD;Berven SH;Schwab FJ;Hamill CL;Horton WC;Ondra SL;Sansur CA;Bridwell KH;

Organisation : Neurosurgery, University of Virginia, Charlottesville, VA 22908, USA. jss7f@virginia.edu

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20683385

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