PMID- 25657104 OWN - NLM STAT- MEDLINE DCOM- 20180102 LR - 20220410 IS - 1432-0932 (Electronic) IS - 0940-6719 (Linking) VI - 25 IP - 8 DP - 2016 Aug TI - Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management. PG - 2433-41 LID - 10.1007/s00586-015-3759-7 [doi] 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. FAU - Sciubba, Daniel M AU - Sciubba DM AD - Department of Neurosurgery, The Johns Hopkins Hospital, 600 N. Wolfe St, Meyer 5-185, Baltimore, MD, 21287, USA. dsciubb1@jhmi.edu. FAU - Scheer, Justin K AU - Scheer JK AD - Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. FAU - Yurter, Alp AU - Yurter A AD - Department of Neurosurgery, The Johns Hopkins Hospital, 600 N. Wolfe St, Meyer 5-185, Baltimore, MD, 21287, USA. FAU - Smith, Justin S AU - Smith JS AD - Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA. FAU - Lafage, Virginie AU - Lafage V AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA. FAU - Klineberg, Eric AU - Klineberg E AD - Department of Orthopaedic Surgery, University of California, Davis, CA, USA. FAU - Gupta, Munish AU - Gupta M AD - Department of Orthopaedic Surgery, University of California, Davis, CA, USA. FAU - Eastlack, Robert AU - Eastlack R AD - San Diego Center for Spinal Disorders, La Jolla, CA, USA. FAU - Mundis, Gregory M AU - Mundis GM AD - San Diego Center for Spinal Disorders, La Jolla, CA, USA. FAU - Protopsaltis, Themistocles S AU - Protopsaltis TS AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA. FAU - Blaskiewicz, Donald AU - Blaskiewicz D AD - Neurosurgical Medical Clinic, San Diego, CA, USA. FAU - Kim, Han Jo AU - Kim HJ AD - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA. FAU - Koski, Tyler AU - Koski T AD - Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. FAU - Kebaish, Khaled AU - Kebaish K AD - Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA. FAU - Shaffrey, Christopher I AU - Shaffrey CI AD - Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA. FAU - Bess, Shay AU - Bess S AD - Rocky Mountain Hospital for Children, Denver, CO, USA. FAU - Hart, Robert A AU - Hart RA AD - Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR, USA. FAU - Schwab, Frank AU - Schwab F AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA. FAU - Ames, Christopher P AU - Ames CP AD - Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA. CN - International Spine Study Group (ISSG) LA - eng PT - Journal Article DEP - 20150206 PL - Germany TA - Eur Spine J JT - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JID - 9301980 SB - IM MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - *Conservative Treatment MH - Databases, Factual MH - Female MH - Humans MH - Male MH - Orthopedic Procedures MH - Pain/etiology MH - Quality of Life MH - Radiography MH - Retrospective Studies MH - Scoliosis/complications/*therapy MH - Spinal Diseases/complications/therapy MH - *Spinal Fusion OTO - NOTNLM OT - 75 years OT - Adult spinal deformity OT - Complications OT - Elderly OT - HRQOL OT - MCID OT - Non-operative OT - Scoliosis EDAT- 2015/02/07 06:00 MHDA- 2018/01/03 06:00 CRDT- 2015/02/07 06:00 PHST- 2014/09/21 00:00 [received] PHST- 2015/01/06 00:00 [accepted] PHST- 2015/01/06 00:00 [revised] PHST- 2015/02/07 06:00 [entrez] PHST- 2015/02/07 06:00 [pubmed] PHST- 2018/01/03 06:00 [medline] AID - 10.1007/s00586-015-3759-7 [pii] AID - 10.1007/s00586-015-3759-7 [doi] PST - ppublish SO - Eur Spine J. 2016 Aug;25(8):2433-41. doi: 10.1007/s00586-015-3759-7. Epub 2015 Feb 6.