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 Otto 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, International Spine Study Group (Issg) The International Spine Study Group (Issg)

Research output: Contribution to journalArticle

28 Citations (Scopus)

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.

Original languageEnglish (US)
JournalEuropean Spine Journal
DOIs
StateAccepted/In press - Feb 6 2015

Fingerprint

Quality of Life
Comorbidity
Reconstructive Surgical Procedures
Scoliosis
Counseling
Decision Making
Body Mass Index
Demography
Databases
Pain
Research
Therapeutics

Keywords

  • 75 years
  • Adult spinal deformity
  • Complications
  • Elderly
  • HRQOL
  • MCID
  • Non-operative
  • Scoliosis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Sciubba, D. M., Scheer, J. K., Yurter, A., Smith, J. S., Lafage, V., Klineberg, E. O., ... The International Spine Study Group (Issg), I. S. S. G. I. (Accepted/In press). Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management. European Spine Journal. https://doi.org/10.1007/s00586-015-3759-7

Patients with spinal deformity over the age of 75 : a retrospective analysis of operative versus non-operative management. / Sciubba, Daniel M.; Scheer, Justin K.; Yurter, Alp; Smith, Justin S.; Lafage, Virginie; Klineberg, Eric Otto; Gupta, Munish; Eastlack, Robert; Mundis, Gregory M.; Protopsaltis, Themistocles S.; Blaskiewicz, Donald; Kim, Han Jo; Koski, Tyler; Kebaish, Khaled; Shaffrey, Christopher I.; Bess, Shay; Hart, Robert A.; Schwab, Frank; Ames, Christopher P.; The International Spine Study Group (Issg), International Spine Study Group (Issg).

In: European Spine Journal, 06.02.2015.

Research output: Contribution to journalArticle

Sciubba, DM, Scheer, JK, Yurter, A, Smith, JS, Lafage, V, Klineberg, EO, Gupta, M, Eastlack, R, Mundis, GM, Protopsaltis, TS, Blaskiewicz, D, Kim, HJ, Koski, T, Kebaish, K, Shaffrey, CI, Bess, S, Hart, RA, Schwab, F, Ames, CP & The International Spine Study Group (Issg), ISSGI 2015, 'Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management', European Spine Journal. https://doi.org/10.1007/s00586-015-3759-7
Sciubba, Daniel M. ; Scheer, Justin K. ; Yurter, Alp ; Smith, Justin S. ; Lafage, Virginie ; Klineberg, Eric Otto ; Gupta, Munish ; Eastlack, Robert ; Mundis, Gregory M. ; Protopsaltis, Themistocles S. ; Blaskiewicz, Donald ; Kim, Han Jo ; Koski, Tyler ; Kebaish, Khaled ; Shaffrey, Christopher I. ; Bess, Shay ; Hart, Robert A. ; Schwab, Frank ; Ames, Christopher P. ; The International Spine Study Group (Issg), International Spine Study Group (Issg). / Patients with spinal deformity over the age of 75 : a retrospective analysis of operative versus non-operative management. In: European Spine Journal. 2015.
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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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T2 - a retrospective analysis of operative versus non-operative management

AU - Sciubba, Daniel M.

AU - Scheer, Justin K.

AU - Yurter, Alp

AU - Smith, Justin S.

AU - Lafage, Virginie

AU - Klineberg, Eric Otto

AU - Gupta, Munish

AU - Eastlack, Robert

AU - Mundis, Gregory M.

AU - Protopsaltis, Themistocles S.

AU - Blaskiewicz, Donald

AU - Kim, Han Jo

AU - Koski, Tyler

AU - Kebaish, Khaled

AU - Shaffrey, Christopher I.

AU - Bess, Shay

AU - Hart, Robert A.

AU - Schwab, Frank

AU - Ames, Christopher P.

AU - The International Spine Study Group (Issg), International Spine Study Group (Issg)

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N2 - 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.

AB - 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.

KW - 75 years

KW - Adult spinal deformity

KW - Complications

KW - Elderly

KW - HRQOL

KW - MCID

KW - Non-operative

KW - Scoliosis

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