title: Spinal deformity in elderly patients: comparison of two distal termination sites of lumbar curve fusion.
abstract: OBJECTIVE
  This report compares the clinical, radiographic, and functional outcomes of fusion from thoracolumbar region terminating at L5 or at sacrum and pelvis in elderly patients with spinal deformity.
  
  
  METHODS
  Ninety-four elderly patients who underwent spinal deformity surgery at our institution were evaluated. Patients were divided into two groups. The group L included 43 patients who underwent fusion of lumbar curve from thoracolumbar region to L5. The group P consisted of 51 patients who were treated using fusion from lower thoracic region to S1 extending to the pelvis. Radiographic outcomes, health-related to the quality of life (HRQOL) parameters, and complications with a 3-year minimum follow-up were analyzed and compared between two groups.
  
  
  RESULTS
  In the group L, the ideal sagittal balance was not achieved. The group P showed a better restoration of global spinal alignments compared with the group L. The HRQOL scores (VAS, ODI, SRS-24) of the patients after 3 years are slightly higher in the group P, but we did not get significant difference between groups. The total number of complications was higher in the group P.
  
  
  CONCLUSIONS
  The research showed that fusion of lumbar curve extending to the pelvis provided good sagittal balance, global spinal alignments, and likely HRQOL parameters after 3-year follow-up. But, eventually, we obtained higher number of complications.
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427. n.zaborovskii@yandex.ru.
authors.forename: Nikita
authors.initials: N
authors.lastname: Zaborovskii
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427.|Orthopedic Department, North-Western State Medical University Named After I.I.Mechnikov, Saint Petersburg, Russia.
authors.forename: Dmitrii
authors.initials: D
authors.lastname: Ptashnikov
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427.
authors.forename: Dmitrii
authors.initials: D
authors.lastname: Mikhaylov
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427.
authors.forename: Oleg
authors.initials: O
authors.lastname: Smekalenkov
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427.
authors.forename: Sergei
authors.initials: S
authors.lastname: Masevnin
authors.affiliation: Spine Surgery and Oncology Service, R.R.Vreden Russian Research Institute of Traumatology and Orthopedics, St. A.Baykova, 8, Saint Petersburg, Russia, 195427.
authors.forename: Olga
authors.initials: O
authors.lastname: Lapaeva
authors.affiliation: Orthopedic Department, North-Western State Medical University Named After I.I.Mechnikov, Saint Petersburg, Russia.
authors.forename: Zabioulah
authors.initials: Z
authors.lastname: Mooraby
mesh_terms: D000368:Aged; D017760:Bone Malalignment / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000002:abnormalities* / Q000601:surgery; D016896:Treatment Outcome
keywords: Complications; Elderly patients; Outcomes; Sacropelvic fixation; Spinal deformity