Spinal Deformity Surgery in Patients ?75 Years Old: How Do the Outcomes Compare with Younger Patients?

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2018

Hypothesis

Patients ?75 yrs old that undergo adult spinal deformity (ASD) surgery will have worse outcomes and more complications compared to a 65-74 age group.

Design

Retrospective study of a prospectively collected database at one center.

Introduction

Up to 68% of the elderly population has spinal deformity which is a growing concern given that avg lifespan is increasing. ASD surgeries are generally taxing and have significant morbidity. We compared outcomes/complications of ASD surgery between 65-74 and ?75 yrs old.

Methods

Radiographic parameters and HRQoL outcomes (VAS/ODI) measured at preop, postop, and 2 yrs. Comorbidities included based on Charlson Comorbidity Index and compared to incidence of complications and need for revision surgery.

Results

176 patients (Group 1=130 aged 65-74, Group 2=46 aged ?75; Subgroup A=0-2 comorbidities, Subgroup B=?3 comorbidities) with average followup of 69.1mo (25-186 mo). No demographic differences other than age and BMI (Group 1 BMI: 27.3, Grp 2 BMI: 23.0, p=0.003) were of significance. Both age groups improved radiographic parameters at all time points. 47.9% of group 1A vs 54.5% in 1B had a complication. 37.8% in group 1A required revision vs 45.5% in 1B. 61.9% of group 2A vs 50.0% in 2B had a complication. 38.1% of group 2A required revision vs 50.0% of 2B. Comparing the different age groups with similar comorbidity burden in regards to complications and need for revision yielded no statistically significant differences (SSD). VAS improvement was similar between the groups at 2 yrs (Group 1: 2.6, Grp 2: 2.5). Both groups improved ODI by 15.4 at 2 yrs. There were no SSD in HRQoL’s between comorbidity subgroups.

Conclusions

No SSD between outcomes/complications of ASD surgery in patients ?75 yrs old compared to age 65-74. ?3 comorbidity burden did not have a significant impact on the complications or need for revision in our elderly ASD surgery population.

Summary

176 elderly patients underwent ASD surgery. Being ?75 yrs old or having ?3 comorbidities did not show a significant difference in HRQoL’s or complications when compared to a 65-74 age group or a lower comorbidity burden in our elderly study population.