Surgery of lumbar and thoracolumbar scolioses in adults over 50. Morbidity and survival in a multicenter retrospective cohort of 180 patients with a mean follow-up of 4.5 years

Summary Introduction The increasing life expectancy of the population and the improvement in surgical and medical management of elderly patients mean that the indication for surgical treatment of adult lumbar and thoracolumbar scolioses has been extended. However the benefit/risk ratio of these proc...

Full description

Saved in:
Bibliographic Details
Published in:Orthopaedics & traumatology, surgery & research surgery & research, 2012-09, Vol.98 (5), p.528-535
Main Authors: Blamoutier, A, Guigui, P, Charosky, S, Roussouly, P, Chopin, D
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Female
Follow-Up Studies
France - epidemiology
Humans
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - surgery
Male
Middle Aged
Morbidity - trends
Orthopedics
Postoperative Complications - epidemiology
Radiography
Retrospective Studies
Risk Factors
Scoliosis - diagnostic imaging
Scoliosis - surgery
Spinal Fusion - adverse effects
Surgery
Survival Rate - trends
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - surgery
Time Factors
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Introduction The increasing life expectancy of the population and the improvement in surgical and medical management of elderly patients mean that the indication for surgical treatment of adult lumbar and thoracolumbar scolioses has been extended. However the benefit/risk ratio of these procedures is still under debate. Materials and methods We reviewed 180 patients, mean age 63 years old with a minimum follow-up of 1 year in a retrospective, continuous, multicenter study. The incidence rate of complications from surgery and the factors influencing their frequency were evaluated by uni- and multivariate analysis. The risk of a second operation was studied by actuarial survival analysis. Results After a mean follow-up of 4.5 years, 79 patients (44%) presented with at least one complication, including 32% with a serious complication. The most frequent complications were mechanical. The risk factors were medical co-morbidities, the extent of fusion and the extent of the preoperative sagittal imbalance. A second operation was necessary in 25% of patients at 1 year and 50% of patients at 6 years of follow-up. Discussion Studies in the literature show that functional results are better with surgical treatment than with medical treatment in the management of thoracic spine and thoracolumbar deformities in patients over 50 years old. An objective assessment of this deformity and associated co-morbidity should make it possible to reduce the rate of complications for this type of surgery. Level of evidence Level IV.
ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2012.04.014