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J. Clin. Med. 2019, 8(4), 483; https://doi.org/10.3390/jcm8040483

Long Term Outcomes and Effects of Surgery on Degenerative Spinal Deformity: A 14-Year National Cohort Study

1
School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
2
Department of Biomedical Engineering, School of Biomedical Science and Engineering, National Yang-Ming University, Taipei 11221, Taiwan
3
Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
4
Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 11221, Taiwan
5
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan
6
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 11221, Taiwan
7
Department of Radiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
*
Author to whom correspondence should be addressed.
Received: 2 April 2019 / Accepted: 8 April 2019 / Published: 10 April 2019
(This article belongs to the Special Issue Spinal Deformity)
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PDF [940 KB, uploaded 10 April 2019]
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Abstract

Degenerative spinal deformity (DSD) has become a prevalent cause of disability and pain among the aging population worldwide. Though surgery has emerged as a promising option for DSD, the natural course, outcomes, and effects of surgery on DSD have remained elusive. This cohort study used a national database to comprehensively follow up patients of DSD for all-cause mortality, respiratory problems, and hip fracture-related hospitalizations. All patients were grouped into an operation or a non-operation group for comparison. An adjustment of demographics, comorbidities, and propensity-score matching was conducted to ameliorate confounders. A Cox regression hazard ratio (HR) model and Kaplan-Meier analysis were also applied. The study comprised 21,810 DSD patients, including 12,544 of the operation group and 9266 of the non-operation group. During the 14 years (total 109,591.2 person-years) of follow-up, the operation group had lower mortality (crude hazard ratio = 0.40), lower respiratory problems (cHR = 0.45), and lower hip fractures (cHR = 0.63) than the non-operation group (all p < 0.001). After adjustment, the risks for mortality and respiratory problems remained lower (adjusted HR = 0.60 and 0.65, both p < 0.001) in the operation than the non-operation group, while hip fractures were indifferent (aHR = 1.08, p > 0.05). Therefore, surgery for DSD is invaluable since it could reduce the risks of mortality and of hospitalization for respiratory problems. View Full-Text
Keywords: Degenerative Spinal Deformity (DSD); mortality; respiratory problems; hip fractures; surgery Degenerative Spinal Deformity (DSD); mortality; respiratory problems; hip fractures; surgery
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Chen, Y.-C.; Huang, W.-C.; Chang, H.-K.; Lirng, J.-F.; Wu, J.-C. Long Term Outcomes and Effects of Surgery on Degenerative Spinal Deformity: A 14-Year National Cohort Study. J. Clin. Med. 2019, 8, 483.

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