Health Related Quality Of Life Outcome After Operative Treatment Of Traumatic Vertebral Fractures In Geriatric Patients.

Abstract

Study background: Quality of life survey conducted after the surgical stabilisation of traumatic thoracic and lumbar vertebral fractures in geriatric patients. Methods: Over a period of 5 years, 42 patients at an age of more than 65 years underwent surgical stabilisation due to an unstable traumatic fracture of the thoracic or lumbar spine. Initially, retrospective empiric data collection was conducted, followed by a prospective radiological and clinical follow-up, including VAS and SF-12. Results: It was possible to conduct a postoperative radiological and clinical follow-up in 31 out of 42 patients (74%) after a mean period of 27.3 months. In 11 out of 42 patients (26%), clinical outcome data were collected by relatives. The mean age at the time of surgery was 71.4 years (range 65 to 87 years), and the injury had almost exclusively been stabilised by using a dorsal internal fixator. The surgical revision rate was 12% (5 out of 42 patients), and postoperative 1-year mortality was also 12% (5 out of 42 patients). At the time of the follow-up, a significant loss of correction was observed in lateral x-ray images when compared to immediate postsurgical results. Quality of life (as measured by SF-12) was significantly reduced at the time of the follow-up compared to a healthy reference population. A significant postoperative decline was also observed with regard to homecare nursing and level of care categories. On the other hand, none of the patients lived in a nursing home, and 35 out of 42 patients (83%) were satisfied or very satisfied with the surgical treatment (as measured by a summary measure). Conclusions: The surgical treatment of traumatic vertebral fractures in geriatric patients resulted in high subjective patient satisfaction post surgery. However, quality of life (SF-12) after an average period of 27.3 months post surgery was still significantly reduced when compared to a healthy reference population.