Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Neurosurg Focus. 2011 Oct;31(4):E3. doi: 10.3171/2011.7.FOCUS11145.
The elderly population (age > 60 years) is the fastest-growing age group in the US. Spinal deformity is a major problem affecting the elderly and, therefore, the demand for surgery for spinal deformity is becoming increasingly prevalent in elderly patients. Much of the literature on surgery for adult deformity focuses on patients who are younger than 60 years, and therefore there is limited information about the complications and outcomes of surgery in the elderly population. In this study, the authors undertook a review of the literature on spinal deformity surgery in patients older than 60 years. The authors discuss their analysis with a focus on outcomes, complications, discrepancies between individual studies, and strategies for complication avoidance.
A systematic review of the MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: "adult scoliosis surgery" and "adult spine deformity surgery." Exclusion criteria included patient age younger than 60 years. Data on major Oswestry Disability Index (ODI) scores, visual analog scale (VAS) scores, patient-reported outcomes, and complications were recorded.
Twenty-two articles were obtained and are included in this review. The mean age was 74.2 years, and the mean follow-up period was 3 years. The mean preoperative ODI was 48.6, and the mean postoperative reduction in ODI was 24.1. The mean preoperative VAS score was 7.7 with a mean postoperative decrease of 5.2. There were 311 reported complications for 815 patients (38%) and 5 deaths for 659 patients (< 1%).
Elderly patient outcomes were inconsistent in the published studies. Overall, most elderly patients obtained favorable outcomes with low operative mortality following surgery for adult spinal deformity.
美国人口老龄化（年龄>60 岁）是增长最快的年龄组。脊柱畸形是影响老年人的主要问题，因此，老年人脊柱畸形手术的需求日益增加。许多成人脊柱畸形手术的文献主要集中在年龄小于 60 岁的患者，因此，关于老年人人群中手术的并发症和结果的信息有限。在这项研究中，作者对 60 岁以上患者的脊柱畸形手术文献进行了回顾。作者讨论了他们的分析，重点是结果、并发症、个别研究之间的差异以及并发症避免策略。
对 MEDLINE 和 PubMed 数据库进行了系统回顾，使用以下关键词搜索自 1950 年至今发表的文章：“成人脊柱侧凸手术”和“成人脊柱畸形手术”。排除标准包括患者年龄小于 60 岁。记录了主要 Oswestry 残疾指数（ODI）评分、视觉模拟评分（VAS）评分、患者报告的结果和并发症的数据。
共获得 22 篇文章并纳入本综述。平均年龄为 74.2 岁，平均随访时间为 3 年。平均术前 ODI 为 48.6，术后 ODI 平均降低 24.1。平均术前 VAS 评分为 7.7，术后平均降低 5.2。815 例患者中有 311 例报告并发症（38%），659 例患者中有 5 例死亡（<1%）。
发表的研究中老年人患者的结果不一致。总体而言，大多数老年患者在接受成人脊柱畸形手术后获得了良好的结果，手术死亡率低。
