Comparison of Surgical Interventions for Degenerative Deformities and Instability of the Spine Among Elderly Patients

Abstract

Objective: To evaluate the surgical results among elderly patients with degenerative deformities and instability of the spine. Methods: A retrospective study of 437 patients (337 women, 100 men) with a mean age 60. The mean follow-up time was five years. The inclusion criteria were diseases and complications following spinal trauma associated with deformities, degenerative processes, acute pain syndrome, and spinal stenosis with neurological deficit. Four study groups (A, B, C and D) were created and defined by type of surgical intervention. Group A patients (the reference group) - decompression of neural structures on both sides without fixation. Group B - decompression and transpedicular fixation performed without correction of the deformity. Group C - patients operated up to the lower-thoracic region with transpedicular screws, correction of the deformity and decompression of spinal stenosis. Group D - transpedicular fixation up to higher-thoracic region; correction of the deformity and decompression of neurological structures. The mean follow-up time was five years. Results: Group D patients achieved the best outcome. The results observed were good in 57.2% of cases (60 patients); satisfactory in 40% of cases (42 patients); and unsatisfactory in 2.8% of cases (three patients). The worst findings were observed in Group A: satisfactory in 13.4% of cases (15 patients); and, unsatisfactory in 86.6% of cases (97 patients). No good results were observed in this group. Conclusion: The results suggest that performing full deformity correction with transpedicular fixation up to the higher-thoracic region gives the best outcomes for elderly patients, and helps to prevent long-term complications. Evidence level III; Retrospective Comparative Study.