Objective:
To analyze the factors influencing efficacy of spinal fusion for the improvement of degenerative scoliosis in elderly patients.
Methods:
Retrospective analysis of clinical data was conducted on 194 elderly patients with degenerative scoliosis treated with minimally invasive lumbar lateral fusion at Affiliated Hospital of Hebei University on February 2018 to February 2021. The patients were divided into a recovered group (n = 138) and an uncured group (n = 56) according to their recovery. The basic information of patients, preoperative complications, preoperative and postoperative imaging results, clinical function scores, postoperative complications, and other relevant information were collected. Logistic regression analysis was used to analyze the factors affecting outcome. Receiver operating characteristic curves were used to determine the predictive value of factors influencing prognosis.
Results:
Univariate analysis showed that, compared to the uncured group, the recovered group showed younger age, shorter duration of symptoms and length of hospital stay, less history of hypertension or diabetes, and lower Oswestry disability index (ODI), and Japanese Orthopedic Association scores (P<0.05). Multivariate retrospective analysis revealed that age, duration of symptoms, length of hospital stay, history of hypertension and pretreatment ODI score were independent risk factors affecting treatment efficacy (P<0.05). The area under the curve of the risk model for predicting efficacy was 0.951.
Conclusion:
Age, duration of symptoms, length of hospital stay, history of hypertension, and pretreatment ODI score are risk factors affecting the treatment outcome of elderly patients with degenerative scoliosis, so these preoperative indications may be indicators to predict efficacy.
Keywords:
Spinal fusion; degenerative scoliosis; disease improvement; influencing factors; old age.