title: Association Between Age and Complications in Adult Scoliosis Surgery: An Analysis of the Scoliosis Research Society Morbidity and Mortality Database.
abstract: METHODS
  Retrospective review.
  
  
  OBJECTIVE
  To assess the relationship between age and complications, and report age-stratified complication rates for the surgical treatment of adult scoliosis.
  
  
  BACKGROUND
  Literature examining age and complication rates for adult scoliosis surgery is conflicting. The Scoliosis Research Society (SRS) morbidity and mortality (M&M) database contains a large series of adult scoliosis patients that can be utilized to investigate this relationship.
  
  
  METHODS
  The SRS M&M database was queried from 2004 to 2007 to identify all cases of adult scoliosis. Data pertaining to patient age, complications, scoliosis, and surgery type were extracted from the database. Age-based analyses of clinical parameters were conducted using age as both a stratified categorical variable and as a continuous variable.
  
  
  RESULTS
  In our cohort of 5470 adult scoliosis patients, the overall complication rate was 13.5% and there was a 0.3% mortality rate. Patients who experienced complications were significantly older than those without complications (55.9 ± 16.5 yrs vs. 51.2 ± 18.7 yrs, P < 0.001). When complications were stratified according to decade of age, there was also a statistically significant trend of increasing complication rates with each decade of life (P < 0.001). Dural tears were the most common complication in patients over 50 years, whereas implant-related complications were the most common in patients less than 50 years.
  
  
  CONCLUSIONS
  There was a clear association between increasing age and higher rates of major short-term complications, a factor that ought to be taken into account during treatment decision making and patient counseling.
authors.affiliation: *School of Medicine, University of New South Wales, Sydney, Australia†Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY‡Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY.
authors.forename: Richard
authors.initials: R
authors.lastname: Shaw
authors.forename: Branko
authors.initials: B
authors.lastname: Skovrlj
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D010027:Osteotomy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012600:Scoliosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D055815:Young Adult