Trends and complications of three-column osteotomy in treating adult spinal deformity in elderly patients: A retrospective analysis

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-03-03 DOI:10.1016/j.jor.2025.03.001

Ved A. Vengsarkar , Jialun Chi , Kate S. Woods , Hanzhi Yang , Zhichang Zhang , Yi Zhang , Jesse Wang , Lawal Labaran , Xudong Li

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引用次数: 0

Abstract

Aims & objectives

Sagittal imbalance linked to adult spinal deformity negatively affects quality of life and can be treated with 3CO techniques. While effective, these methods are invasive and can lead to high complications. Since 2010, a more patient-focused approach has grown in popularity, but its effects on elderly patients remain unclear. This retrospective study aimed to investigate the trend of three-column osteotomy (3CO) utilization in posterior long-segment fusion among different age groups. We also sought to determine the safety profile of 3CO by analyzing postoperative complications in the elderly population.

Materials & methods

The study assessed postoperative complications and long-term outcomes for elderly patients aged 70 and above who underwent 3CO as part of a posterior spinal instrumented fusion from 2010 to 2020 using multivariable logistic regression. A total of 2091 patients were identified for analysis.

Results

The Mann-Kendall trend test revealed a significant downward trend in 3CO interventions after 2017. Elderly patients demonstrated higher rates of medical complications compared to younger cohorts but had lower rates of surgical complications and reoperations. This pattern persisted even after adjusting for baseline comorbidity profiles. At the five-year mark, elderly patients (ages 70–84) exhibited reoperation rates similar to the middle-aged group (ages 55–69) but notably lower than those in patients younger than 55 years.

Conclusion

Aside from an increased risk of medical complications following 3CO, older patients were not at an increased risk of surgical complications, including pseudarthrosis, proximal junctional failure, and reoperation.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.