European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Multicenter Study
Influence of previous surgery on patient-rated outcome after surgery for degenerative disorders of the lumbar spine.
Few studies have used multivariate models to quantify the effect of multiple previous spine surgeries on patient-oriented outcome after spine surgery. This study sought to quantify the effect of prior spine surgery on 12-month postoperative outcomes in patients undergoing surgery for different degenerative disorders of the lumbar spine. ⋯ We were able to demonstrate a clear "dose-response" effect for previous surgery: the greater the number of prior spine surgeries, the systematically worse the outcome at 12 months' follow-up. The results of this study can be used when considering or consenting a patient for further surgery, to better inform the patient of the likely outcome and to set realistic expectations.
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The goal of the present study was to compare the outcomes of operative and non-operative patients with adult spinal deformity (ASD) over 75 years of age. ⋯ In the largest series to date comparing operative and non-operative management of adult spinal deformity in elderly patients greater than 75 years of age, reconstructive surgery provides significant improvements in pain and disability over a 2-year period. Furthermore, operative patients were more likely to reach MCID than non-operative patients. When counseling elderly patients with ASD, such data may be helpful in the decision-making process regarding treatment.
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To investigate the change of pulmonary function in adult scoliosis patients with respiratory dysfunction undergoing HGT combined with assisted ventilation. ⋯ The results of our study revealed that combined HGT and assisted ventilation would be beneficial to pulmonary function improvement in severe adult scoliosis cases, most of which were young adults.
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Few studies have examined the effectiveness of surgical treatment for adult degenerative scoliosis (ADS) using validated patient-orientated outcome instruments. This study reports patient outcomes in a large, consecutive series of patients being treated for ADS by simple decompression (D), short fusion (SF), or long fusion (LF). ⋯ Despite the complexity of the disease, patient-orientated outcomes after surgery for ADS were similar to those previously reported using the same outcome instruments in patients with lumbar stenosis and degenerative spondylolisthesis. The use of D, SF and LF for ADS yielded similarly good results from the patient's perspective. This most likely reflects careful and appropriate patient selection. Further analyses are warranted to identify baseline variables predicting the 26-31 % cases in each group with a poor outcome.