Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older: A prospective study with minimum two-year follow-up

Ryan M. Zimmerman, Ahmed S. Mohamed, Richard Skolasky, Malaya D. Robinson, Khaled M Kebaish

Research output: Contribution to journalArticle

Abstract

Study Design. A prospective study. Objective. Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged ≥ 40 years undergoing primary surgical treatment for scoliosis. Summary of Background Data. Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged ≥ 40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. Methods. We prospectively studied a consecutive series of 35 patients of age ≥ 40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86%) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P <0.05) correlations. Results. The overall complications rate was 49%; 26% of the patients had a major complication and 31% had a minor one. There were no deaths. Coronal curve correction was 30.8° (61%) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. Conclusion. Adults ≥ 40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.

Original languageEnglish (US)
Pages (from-to)1861-1866
Number of pages6
JournalSpine
Volume35
Issue number20
DOIs
StatePublished - Sep 15 2010

Fingerprint

Scoliosis
Prospective Studies
Comorbidity
Sacrum
Research
Quality of Life
Therapeutics

Keywords

  • adult
  • complications
  • outcomes
  • prospective
  • scoliosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older : A prospective study with minimum two-year follow-up. / Zimmerman, Ryan M.; Mohamed, Ahmed S.; Skolasky, Richard; Robinson, Malaya D.; Kebaish, Khaled M.

In: Spine, Vol. 35, No. 20, 15.09.2010, p. 1861-1866.

Research output: Contribution to journalArticle

@article{d1785d915f6e4af79677e26373450be1,
title = "Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older: A prospective study with minimum two-year follow-up",
abstract = "Study Design. A prospective study. Objective. Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged ≥ 40 years undergoing primary surgical treatment for scoliosis. Summary of Background Data. Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged ≥ 40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. Methods. We prospectively studied a consecutive series of 35 patients of age ≥ 40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86{\%}) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P <0.05) correlations. Results. The overall complications rate was 49{\%}; 26{\%} of the patients had a major complication and 31{\%} had a minor one. There were no deaths. Coronal curve correction was 30.8° (61{\%}) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. Conclusion. Adults ≥ 40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.",
keywords = "adult, complications, outcomes, prospective, scoliosis",
author = "Zimmerman, {Ryan M.} and Mohamed, {Ahmed S.} and Richard Skolasky and Robinson, {Malaya D.} and Kebaish, {Khaled M}",
year = "2010",
month = "9",
day = "15",
doi = "10.1097/BRS.0b013e3181e57827",
language = "English (US)",
volume = "35",
pages = "1861--1866",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "20",

}

TY - JOUR

T1 - Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older

T2 - A prospective study with minimum two-year follow-up

AU - Zimmerman, Ryan M.

AU - Mohamed, Ahmed S.

AU - Skolasky, Richard

AU - Robinson, Malaya D.

AU - Kebaish, Khaled M

PY - 2010/9/15

Y1 - 2010/9/15

N2 - Study Design. A prospective study. Objective. Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged ≥ 40 years undergoing primary surgical treatment for scoliosis. Summary of Background Data. Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged ≥ 40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. Methods. We prospectively studied a consecutive series of 35 patients of age ≥ 40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86%) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P <0.05) correlations. Results. The overall complications rate was 49%; 26% of the patients had a major complication and 31% had a minor one. There were no deaths. Coronal curve correction was 30.8° (61%) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. Conclusion. Adults ≥ 40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.

AB - Study Design. A prospective study. Objective. Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged ≥ 40 years undergoing primary surgical treatment for scoliosis. Summary of Background Data. Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged ≥ 40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. Methods. We prospectively studied a consecutive series of 35 patients of age ≥ 40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86%) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P <0.05) correlations. Results. The overall complications rate was 49%; 26% of the patients had a major complication and 31% had a minor one. There were no deaths. Coronal curve correction was 30.8° (61%) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. Conclusion. Adults ≥ 40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.

KW - adult

KW - complications

KW - outcomes

KW - prospective

KW - scoliosis

UR - http://www.scopus.com/inward/record.url?scp=77957361399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957361399&partnerID=8YFLogxK

U2 - 10.1097/BRS.0b013e3181e57827

DO - 10.1097/BRS.0b013e3181e57827

M3 - Article

C2 - 20802387

AN - SCOPUS:77957361399

VL - 35

SP - 1861

EP - 1866

JO - Spine

JF - Spine

SN - 0362-2436

IS - 20

ER -