Complications in the Elderly Population Undergoing Spinal Deformity Surgery: A Systematic Review and Meta-Analysis.

Autor:	Alvarez Reyes A; Department of Neurosurgery, 3158Banner University of Arizona Medical Center - Tucson, Tucson AZ, USA., Jack AS; Division of Neurosurgery, 23534University of Alberta, Edmonton, Alberta, Canada., Hurlbert RJ; Department of Neurosurgery, 3158Banner University of Arizona Medical Center - Tucson, Tucson AZ, USA., Ramey WL; Department of Neurological Surgery, 22165Houston Methodist Hospital, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2022 Oct; Vol. 12 (8), pp. 1934-1942. Date of Electronic Publication: 2022 Feb 27.
DOI:	10.1177/21925682221078251
Abstrakt:	Study Design: Systematic Review and Meta-Analysis. Objectives: The elderly have an increased risk of perioperative complications for Adult Spinal Deformity (ASD) corrections. Stratification of these perioperative complications based on risk type and specific risk factors, however, remain unclear. This paper will systematically review perioperative risk factors in the elderly undergoing ASD correction stratified by type: medical, implant-related, proximal junctional kyphosis (PJK), and need for revision surgery. Methods: A systematic review was performed using the PRISMA guidelines. A query of PubMed was performed to identify publications pertinent to ASD in the elderly. Publications included in this review focused on patients ≥65 years old who underwent operative management for ASD to assess for risk factors of perioperative complications. Results: A total of 734 unique citations were screened resulting in ten included articles for this review. Pooled incidence of perioperative complications included medical complications (21%), implant-related complications (16%), PJK (29%), and revision surgery (13%). Meta-analysis calculated greater preoperative PT (WMD 2.66; 95% Cl .36-4.96; P = .02), greater preoperative SVA (WMD 2.24; 95% Cl .62-3.86; P = .01), and greater postoperative SVA (WMD .97; 95% Cl .03-1.90; P = .04) to significantly correlate with development of PJK with no evidence of publication bias or concerns in study heterogeneity. Conclusions: There is a paucity of literature describing perioperative complications in the elderly following ASD surgery. Appropriate understanding of modifiable risk factors for the development of medical and implant-related complications, proximal junctional kyphosis, and revision surgeries presents an opportunity to decrease morbidity and improve patient outcomes.
Databáze:	MEDLINE
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