• Eur Spine J · Aug 2016

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

    • Daniel M Sciubba, Justin K Scheer, Alp Yurter, Justin S Smith, Virginie Lafage, Eric Klineberg, Munish Gupta, Robert Eastlack, Gregory M Mundis, Themistocles S Protopsaltis, Donald Blaskiewicz, Han Jo Kim, Tyler Koski, Khaled Kebaish, Christopher I Shaffrey, Shay Bess, Robert A Hart, Frank Schwab, Christopher P Ames, and International Spine Study Group (ISSG).
    • Department of Neurosurgery, The Johns Hopkins Hospital, 600 N. Wolfe St, Meyer 5-185, Baltimore, MD, 21287, USA. dsciubb1@jhmi.edu.
    • Eur Spine J. 2016 Aug 1; 25 (8): 2433-41.

    PurposeThe 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.MethodsA 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.Results27 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).ConclusionsIn 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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