Functional Outcomes and Complications After Primary Spinal Surgery for Scoliosis in Adults Aged Forty Years or Older
Bibliographic record
Abstract
STUDY DESIGN: A prospective study. OBJECTIVE: Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged ≥ 40 years undergoing primary surgical treatment for scoliosis. SUMMARY OF BACKGROUND DATA: Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged ≥ 40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. METHODS: We prospectively studied a consecutive series of 35 patients of age ≥ 40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86%) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P < 0.05) correlations. RESULTS: The overall complications rate was 49%; 26% of the patients had a major complication and 31% had a minor one. There were no deaths. Coronal curve correction was 30.8° (61%) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. CONCLUSION: Adults ≥ 40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".