Patients with spinal deformity over the age of 75: a retrospective analysis of operative versus non-operative management Daniel M. SciubbaJustin K. ScheerAlp YurterJustin S. SmithVirginie LafageEric Klineberg • Munish GuptaRobert EastlackGregory M. MundisThemistocles S. ProtopsaltisDonald Blaskiewicz • Han Jo KimTyler KoskiKhaled KebaishChristopher I. ShaffreyShay BessRobert A. Hart • Frank SchwabChristopher P. Amesthe International Spine Study Group (ISSG)

Purpose 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. Methods A retrospective review of a multicenter prospective adult spinal deformity database was conducted examining patients with ASD over the age of 75 years. Demographics, comorbidities, operation-related variables, complications, radiographs, and Health-related quality of life (HRQOL) measures collected included Oswestry Disability Index, Short Form-36, and Scoliosis Research Society-22 preoperatively, and at 1 and 2 years later. Minimum clinically important difference (MCID) was calculated and also compared. Results 27 patients (12 operative, 15 non-operative) were studied. There were no significant differences (p [ 0.05) between operative and non-operative patients for age, body mass-index, and comorbidities, but operative patients had worse baseline HRQOL than non-operative patients. Operative patients had a significant improvement in radiographic parameters in 2-year HRQOL, whereas non-operative patients did not (p [ 0.05). Operative patients were significantly more likely to reach MCID (range 41.7‐81.8 vs. 0‐33.3 %, p \ 0.05). In the surgical group, 9 (75 %) patients had at least 1 complication (24 total complications). Conclusions 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