Rigorous Correction of Sagittal Vertical Axis Is Correlated With Better ODI Outcomes After Extensive Corrective Fusion in Elderly or Extremely Elderly Patients With Spinal Deformity

被引：17

作者：

Yamato, Yu ^{[1
]}

Hasegawa, Tomohiko ^{[1
]}

Togawa, Daisuke ^{[1
,2
]}

Yoshida, Go ^{[1
]}

Banno, Tomohiro ^{[1
]}

Arima, Hideyuki ^{[1
]}

Oe, Shin ^{[1
,2
]}

Mihara, Yuki ^{[1
]}

Ushirozako, Hiroki ^{[1
]}

Kobayashi, Sho ^{[1
]}

Yasuda, Tatsuya ^{[3
]}

Matsuyama, Yukihiro ^{[1
]}

机构：

[1] Hamamatsu Univ Sch Med, Dept Orthoped Surg, 1 Chome 20-1, Hamamatsu, Shizuoka 4313192, Japan

[2] Hamamatsu Univ Sch Med, Div Geriatr Musculoskeletal Hlth, 1 Chome 20-1, Hamamatsu, Shizuoka 4313192, Japan

[3] Hamamatsu Med Ctr, Dept Orthoped Surg, Naka Ku, 328 Tomizuka Cho, Hamamatsu, Shizuoka 4328580, Japan

来源：

SPINE DEFORMITY | 2019年 / 7卷 / 04期

关键词：

Adult spinal deformity; Elderly patient; Surgical outcome; Spinopelvic parameter; Age difference;

D O I：

10.1016/j.jspd.2018.11.001

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study DesignRetrospective analysis of a prospectively collected consecutive case series.ObjectivesTo determine the effect of spinopelvic correction on clinical outcomes and discuss the approach to target alignment in elderly or extremely elderly spinal deformity patients.Summary of Background DataAge-dependent target alignment during corrective fusion surgery in elderly patients remains controversial. Age-related target spinal alignment should be examined based on the outcomes data of patients with fused, nonphysiological spines.MethodsConsecutive adult spinal deformity (ASD) patients aged 45 years or older who underwent thoracolumbar corrective fusion of at least five levels were included. Spinopelvic radiographic parameters, health-related quality of life (Oswestry Disability Index [ODI]), and the scores on a numeric rating scale of low back pain were investigated before and after the operation. The patients were stratified into three groups according to age as follows: Middle-Age, 45-64 years; Elderly, 65-74 years; and Extremely Elderly, >= 75 years. We also stratified the patients into three groups according to lumber lordosis (LL) as follows: ideal (within 5 degrees of ideal LL), moderate (between -5 degrees and -20 degrees of ideal LL), and under (under ideal LL by -20 degrees).ResultsA total of 149 patients (Middle-Age, 38; Elderly, 68; and Extremely Elderly, 43) were included in this study. No significant difference was observed in any of the radiographic parameters in each age group. The ODI and numeric rating scale scores of the ideal-correction group at two years after surgery were significantly better than those of the undercorrection group across all ages. A significant correlation with ODI was observed between sagittal spinopelvic parameters in the Elderly and Extremely Elderly groups. A stronger correlation was observed in the Extremely Elderly group compared with the Elderly group.ConclusionsRigorous realignment of sagittal vertical axis is correlated with ODI outcomes, especially in very elderly patients.Level of EvidenceLevel 4.

引用

页码：610 / 618

页数：9

共 45 条

[21] Defining Spino-Pelvic Alignment Thresholds Should Operative Goals in Adult Spinal Deformity Surgery Account for Age? [J].