Clinical results and functional outcomes in adult patients after revision surgery for spinal deformity correction: Patients younger than 65 years versus 65 years and older

Study Design: Retrospective comparison. Objective: To compare complications and radiographic and functional outcomes of patients undergoing revision spinal deformity surgery, who were 40-64 years of age and 65 years of age or older. Summary of Background Data: The effect of age on radiographic and functional outcomes has not been well established in the literature for patients undergoing revision adult deformity surgery. The hypothesis was that the complications and radiographic and functional outcomes of younger and older adult patients would be comparable. Methods: The authors retrospectively reviewed prospectively collected data on 109 consecutive patients (84 women and 25 men) undergoing revision spinal deformity surgery who were 40 years of age or older. All surgeries were performed at 1 institution by the senior author. Patients were divided into groups based on age: younger than 65 years of age (70 patients) or 65 years of age or older (39 patients), and complications and radiographic and functional outcomes were compared. All patients had at least 2 years' clinical follow-up. Hotelling's t² test and the χ² test were used to compare differences; statistical significance was set at p <.05. Results: There was no significant difference between the 2 groups in major complications (p =.62), minor complications (p =.34), or reoperation rate (p =.08). Major correction was achieved in the coronal and sagittal planes in both groups after surgery. By final follow-up, patients in both groups had significant improvements from baseline in Oswestry disability index (p <.05) and in all Scoliosis Research Society-22 domains (p <.001); there was no significant difference in any domain score between groups (p >.05). Conclusions: Older adult patients undergoing revision deformity correction surgery achieved functional outcome benefits comparable to those in younger adults without significantly more complications. Surgeons should be aware of these factors when counseling patients regarding revision surgery for deformity correction.