Abstract
Evidence suggests that increasing age raises the risk for higher complications with traditional open deformity surgery. The decreased exposure related morbidity associated with minimally invasive surgery (MIS) has the potential to lower the complication profile in older surgical patients.
To evaluate the impact of age on complications and reoperations.
Prospective outcomes registry.
A total of 142 patients.
Complications and reoperations.
Inclusion criteria included age ≥ 18 years, and at least one of the following criteria: coronal curve (CC) ≥ 20°, sagittal vertical axis (SVA) > 5 cm, pelvic tilt (PT) > 25°, or thoracic kyphosis (TK) > 60°. Complications (major/minor) and reoperations were collected. A total of 142 patients who underwent circumferential MIS surgery were divided into younger (≤65 yrs, N=45) and older (>65 yrs, N=97) groups. Chi-square and t-test analyses were performed.
Mean age was 57 years (SD±10) in the younger and 73.7yrs (SD±4.8) in the older groups (p<0.001). There were no significant differences in gender (F:76% vs F:66%), BMI (28.2 vs 29.0), frailty (3.7 vs 3.3), interbody levels fused (3.0 vs 3.3), posterior levels fused (4.8 vs 5.6) between younger and older groups, respectively. CCI was significantly lower in the younger (1.64) vs older (2.4) group (p=0.014). Total complications did not differ between younger (48.9%, N=22) and older (47.4%, N=46) patients (p=0.8). Major complications occurred in 11.1% of younger and 7.2% of older patients (p=0.317). Minor complications occurred in 17.8% of younger and 18.6% of older patients (p=0.555). Both major and minor complications occurred in 11.1% of younger and 6.2% of older patients (p=0.242). Reoperations were significantly less in the younger (4.4%, N=2) compared to the older (16.5%, N=16) (p=0.035). Follow-up was 12.8 months in the younger and 12.5 months in the older group.
Despite significantly more comorbidities, total complications were not higher in elderly patients undergoing MIS surgery. However, elderly patients were found to have a higher reoperation rate, with PJK and instrumentation failure/mal-positioning being the most frequent reasons.
This abstract does not discuss or include any applicable devices or drugs.