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Scoliosis Surgery Has More Risks, Benefits for Elderly

Elderly have higher risk of complications, but may gain greater improvement in disability and pain

TUESDAY, May 3 (HealthDay News) -- Elderly patients who undergo surgery for scoliosis have an increased risk of complications but may experience greater improvement in disability and pain than younger patients, according to a study published in the May 1 issue of Spine.

Justin S. Smith, M.D., Ph.D., from the University of Virginia in Charlottesville, and colleagues evaluated the effect of age on the incidence of complications and outcomes related to surgery in patients with scoliosis. Patients with scoliosis (Cobb ≥30 degrees), aged 25 to 85 years, were assessed before and two years after surgery using the Oswestry Disability Index (ODI), Short Form-12 (SF-12), Scoliosis Research Society-22 (SRS-22), and numerical rating scale (NRS) for back and leg pain.

The investigators found that perioperative complication rates increased significantly with age and were seen in 17 percent of patients aged 25 to 44 years, 41 percent of those aged 45 to 64 years, and 71 percent of those aged 65 to 85 years. Compared to younger patients, elderly patients had significantly increased disability, poorer health status, and more severe back and leg pain at baseline. Two years after surgery, all patients had significant improvements in ODI, SRS-22, and back and leg pain; those aged 45 to 85 had significantly improved SF-12 physical component scores (PCS). Elderly patients had significantly greater improvement in ODI and leg pain NRS, and improvements in SF-12 PCS, SRS-22, and back pain NRS compared to younger patients.

"The elderly, despite facing the greatest risk of complications, may stand to gain a disproportionately greater improvement in disability and pain with surgery," the authors write.

Several authors disclosed financial ties with the medical industry. The study group was supported by Medtronic.

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