Deformity Surgery Riskier Than Spondy or Stenosis Surgery?

A team of researchers from Japan have assessed how 481 patients fared postoperatively if they were frail and had comorbidities. Their work, “Impact of Frailty and Comorbidities on Surgical Outcomes and Complications in Adult Spinal Disorders,” appears in the September 15, 2018 edition of Spine.

Mitsuru Yagi, M.D., Ph.D., with the Department of Orthopedic Surgery at the Keio University School of Medicine in Tokyo, Japan, and co-author described the rationale behind his study to OTW, “Surgical treatment of spinal disorders is invasive, and patients often develop severe complications particularly if they have spinal deformity and are among the geriatric population.”

“Therefore, it is important to predict the poor improvement and prevent the development of complications after corrective spine surgery. We reported the impact of frailty and comorbidities for the surgical treatment of elective spine surgery for adult spinal deformity, degenerative lumbar spondylolisthesis, and lumbar spinal canal stenosis.”

The authors wrote, “We retrospectively reviewed the results of consecutive elective spine surgeries for 156 adult spinal deformities, 152 degenerative spondylolisthesis, or 173 lumbar spinal canal stenosis with follow-up of at least 2 years. Modified Frailty Index (mFI) and Charlson Comorbidity Index (CCI) were determined from baseline demographics…”

Dr. Yagi told OTW, “Adult spinal deformity subjects were relatively frail and had more comorbidities compared to spondylolisthesis subjects. Surgical outcomes and complication rates worsened as the mFI and CCI increased in adult deformity subjects, whereas favorable outcomes and acceptable complication rates were achieved in spondylolisthesis and lumbar spinal canal stenosis subjects regardless of increased frailty and CCI. Careful patient selection and preoperative treatment of comorbidities may decrease surgical complications and improve clinical outcomes for the surgical treatment of ASD.”