[The effect of spinal deformity correction on the quality of life of elderly patients].

AIM At present, there is no consensus on the approach to treatment of patients older than 60 years of age who have spinal deformity and clinical symptoms. The article describes the effect of two different types of surgery on the quality of life of elderly patients with deformities. MATERIAL AND METHODS A prospective study included 58 patients operated on at the Verden Russian Research Institute of Traumatology and Orthopedics in the period between 2007 and 2010. The inclusion criteria were as follows: patients older than 60 years of age, having spinal deformity (sagittal modifiers of grade 2(+) and higher according to the SRS-Schwab classification), radicular syndromes, and back pain. The patients were examined in accordance with a general algorithm, including general clinical and neurological examinations and an X-ray examination with evaluation of deformity, spinopelvic relationships, and sagittal imbalance. We compared two groups of patients. The first group included 28 patients who underwent decompressive foraminotomy. The second group consisted of 30 patients who underwent decompressive foraminotomy and deformity correction. The patients were evaluated using the following scales: VAS, ODI, and SRS-24 before surgery and after 3, 6 months, 1, 2, and 5 years. RESULTS Preoperatively, there was no difference between the groups. We found no differences between the groups 1 year after surgery. After 5 years, the group with isolated decompression had poorer results. CONCLUSION Spinal deformity correction is a more aggressive surgical procedure compared to isolated decompression. However, the efficacy of the former operation is higher.

[1]  D. Haschtmann,et al.  Adult degenerative scoliosis: comparison of patient-rated outcome after three different surgical treatments , 2016, European Spine Journal.

[2]  N. Kawamura,et al.  Radiological Improvements in Global Sagittal Alignment After Lumbar Decompression Without Fusion , 2015, Spine.

[3]  H. Kautiainen,et al.  Changes in Health Utility, Disability, and Health-Related Quality of Life in Patients After Spinal Fusion: A 2-Year Follow-up Study , 2014, Spine.

[4]  Kai-Ming G. Fu,et al.  Patients With Adult Spinal Deformity Treated Operatively Report Greater Baseline Pain and Disability Than Patients Treated Nonoperatively; However, Deformities Differ Between Age Groups , 2014, Spine.

[5]  Kai-Ming G. Fu,et al.  The minimally invasive spinal deformity surgery algorithm: a reproducible rational framework for decision making in minimally invasive spinal deformity surgery. , 2014, Neurosurgical focus.

[6]  K. Radcliff,et al.  Cost and Value of Spinal Deformity Surgery , 2014, Spine.

[7]  Munish C. Gupta,et al.  Poor Psychosocial Profile Reported by SF 36, SRS 22r and DRAM Does Not Predict Outcome Following , 2013 .

[8]  Oheneba Boachie-Adjei,et al.  Radiographical Spinopelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Prospective Multicenter Analysis , 2013, Spine.

[9]  L. Lenke,et al.  Does Correction of Preoperative Coronal Imbalance Make a Difference in Outcomes of Adult Patients With Deformity? , 2013, Spine.

[10]  T. Matsuno,et al.  Epidemiology of Degenerative Lumbar Scoliosis: A Community-Based Cohort Study , 2012, Spine.

[11]  J. Buchowski,et al.  Scoliosis Research Society—Schwab Adult Spinal Deformity Classification: A Validation Study , 2012, Spine.

[12]  F. Girardi,et al.  Degenerative Scoliosis: A Review , 2011, HSS Journal ®.

[13]  L. Lenke,et al.  The Scoliosis Research Society Health-Related Quality Of Life (SRS-30) Age–Gender Normative Data: An Analysis of 1346 Adult Subjects Unaffected by Scoliosis , 2011, Spine.

[14]  R. Deyo,et al.  Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. , 2010, JAMA.

[15]  M. Maltenfort,et al.  Adult scoliosis surgery outcomes: a systematic review. , 2010, Neurosurgical focus.

[16]  Joseph H. Perra,et al.  Can C7 Plumbline and Gravity Line Predict Health Related Quality of Life in Adult Scoliosis? , 2009, Spine.

[17]  L. Lenke,et al.  Age-Gender Matched Comparison of SRS Instrument Scores Between Adult Deformity and Normal Adults: Are All SRS Domains Disease Specific? , 2008, Spine.

[18]  R. Winter,et al.  Surgical Outcomes of Decompression, Decompression With Limited Fusion, and Decompression With Full Curve Fusion for Degenerative Scoliosis With Radiculopathy , 2008, Spine.

[19]  L. Lenke,et al.  The Selection of Operative Versus Nonoperative Treatment in Patients With Adult Scoliosis , 2007, Spine.

[20]  M. Takemitsu,et al.  A Prospective Study of De Novo Scoliosis in a Community Based Cohort , 2006, Spine.

[21]  M. Aebi The adult scoliosis , 2005, European Spine Journal.

[22]  F. Schwab,et al.  Adult Scoliosis: Prevalence, SF-36, and Nutritional Parameters in an Elderly Volunteer Population , 2005, Spine.

[23]  F. Schwab,et al.  Adult Scoliosis: A Health Assessment Analysis by SF-36 , 2003, Spine.

[24]  F. Schwab,et al.  Adult Scoliosis: A Quantitative Radiographic and Clinical Analysis , 2002, Spine.

[25]  A. Vaccaro,et al.  Adult degenerative lumbar scoliosis. Commentary , 2003 .