AI Article Synopsis
- The prevalence of adult deformity surgery is rising among elderly individuals, prompting the need for spine surgeons to consider various preoperative and intraoperative factors specific to this age group to minimize surgical complications.
- Degenerative scoliosis affects a significant portion of the elderly (68%), with complication rates after surgery ranging from 37% to 62%, influenced by factors like age, comorbidities, and bone quality, underscoring the importance of effective risk management.
- Comprehensive perioperative management, including assessing frailty and nutritional status preoperatively and employing strategies to reduce blood loss intraoperatively, is essential to improve surgical outcomes in geriatric patients.
Article Abstract
Introduction: Prevalence of adult deformity surgery in the elderly individuals continues to increase. These patients have additional considerations for the spine surgeon during surgical planning. We perform an informative review of the spinal and geriatric literature to assess preoperative and intraoperative factors that impact surgical complication occurrences in this population.
Significance: There is a need to understand surgical risk assessment and prevention in geriatric patients who undergo thoracolumbar adult deformity surgery in order to prevent complications.
Methods: Searches of relevant biomedical databases were conducted by a medical librarian. Databases searched included MEDLINE, Web of Science, CINAHL, IPA, Cochrane, PQ Health and Medical, SocINDEX, and WHO's Global Health Library. Search strategies utilized Medical Subject Headings plus text words for extensive coverage of scoliosis and surgical technique concepts.
Results: Degenerative scoliosis affects 68% of the geriatric population, and the rate of surgical interventions for this pathology continues to increase. Complications following spinal deformity surgery in this patient population range from 37% to 62%. Factors that impact outcomes include age, comorbidities, blood loss, and bone quality. Using these data, we summarize multimodal risk prevention strategies that can be easily implemented by spine surgeons.
Conclusions: After evaluation of the latest literature on the complications associated with adult deformity surgery in geriatric patients, comprehensive perioperative management is necessary for improved outcomes. Preoperative strategies include assessing physiological age via frailty score, nutritional status, bone quality, dementia/delirium risk, and social activity support. Intraoperative strategies include methods to reduce blood loss and procedural time. Postoperatively, development of a multidisciplinary team approach that encourages early ambulation, decreases opiate use, and ensures supportive discharge planning is imperative for better outcomes for this patient population.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540502 | PMC |
| http://dx.doi.org/10.1177/2151459319851681 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery.
J Neurosurg Spine
January 2025
6Presbyterian St. Lukes Medical Center, Denver, Colorado.
Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.
View Article and Find Full Text PDFFinite element analysis of the plantar support for the medial longitudinal arch with flexible flatfoot.
PLoS One
January 2025
Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
Purpose: The present study is to explore the appropriate plantar support force for its effect on improving the collapse of the medial longitudinal arch with flexible flatfoot.
Methods: A finite element model with the plantar fascia attenuation was constructed simulating as flexible flatfoot. The appropriate plantar support force was evaluated.
Quality of Life in Patients With Acquired Anophthalmia Using an Ocular Prosthesis.
Ophthalmic Plast Reconstr Surg
January 2025
Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, U.S.A.
Purpose: To employ a validated survey for evaluation of quality of life (QoL) outcomes and associated factors in a US cohort of adult patients with acquired anophthalmia wearing a prosthesis.
Methods: A retrospective cohort study was performed at a single, US academic institution of patients cared for between 2012 and 2021. The electronic medical record database was queried for adult patients with a history of evisceration or enucleation surgery and placement of an orbital implant.
A NOTCH3 pathogenic variant influences osteogenesis and can be targeted by antisense oligonucleotides in induced pluripotent stem cells.
PLoS One
January 2025
Ionis Pharmaceuticals, Inc., Carlsbad, CA, United States of America.
Lateral Meningocele Syndrome (LMS), a disorder associated with NOTCH3 pathogenic variants, presents with neurological, craniofacial and skeletal abnormalities. Mouse models of the disease exhibit osteopenia that is ameliorated by the administration of Notch3 antisense oligonucleotides (ASO) targeting either Notch3 or the Notch3 mutation. To determine the consequences of LMS pathogenic variants in human cells and whether they can be targeted by ASOs, induced pluripotent NCRM1 and NCRM5 stem (iPS) cells harboring a NOTCH36692-93insC insertion were created.
View Article and Find Full Text PDFIdentification of degenerative precursors at the wrist with advanced imaging: current updates.
J Hand Surg Eur Vol
January 2025
Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Articular malalignment and ulnocarpal impaction can progress to osteoarthritis in the wrist. This may be triggered by tears of the scapholunate ligament (rarely the lunotriquetral ligament) or the foveal lamina of the triangular fibrocartilage complex. In the pre-degenerative stages, radiographic findings are inconclusive, and symptoms may be absent or discrete.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!