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Quality of life outcomes in surgically treated adult scoliosis patients: a systematic review

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The aim of this systematic review was to identify prospective studies reporting the impact of surgical intervention on health-related quality of life (HRQL) outcomes for adults with scoliosis at a minimum 2 year follow-up.


An electronic database search was conducted for January 2000–November 2013 in conjunction with a reference list search of two related systematic reviews for prospective studies of adults with scoliosis reporting HRQL outcome measure. Methodological quality of included articles was assessed using the Downs and Black checklist. Cohen’s d effect size was calculated for Scoliosis Research Society Questionnaire (SRS) and Oswestry Disability Index (ODI) outcomes for included studies and pooled data.


The database and reference list searches returned 349 potential articles; three articles met the inclusion criteria. Downs and Black scores ranged from 18/28 to 21/28 (fair–good quality evidence). Total number of 188 patients were treated surgically and had a mean age of 38 years or older. All studies showed significant improvement in reported HRQL outcomes for at least a 2 year follow-up. The Cohen’s d effect size for SRS was d = 1.4 (n = 188, 95 % CI; 0.9, 1.8) and for ODI d = 0.9 (n = 120, 95 % CI; 0.4, 1.4).


Findings from this review suggest surgery improves HRQL in patients with adult scoliosis at a minimum 2 year follow-up. However, these findings are based on limited data of fair to good quality which needs to be taken into consideration when interpreting the results and highlights the need for additional high quality prospective studies.

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We gratefully acknowledge Brenda Sides from the research team of Lawrence G. Lenke, M.D., Washington University School of Medicine, for providing the SRS data from the Rose et al. [22] study. We would also like to acknowledge an anonymous reviewer for helpful comments during manuscript preparation. This study was financially supported by funds from the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, Karolinska Institutet research funds, and the Swedish Research Council (Projects K2013-99X-22268-01-3 and K2013-52X-22198-01-3).

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Correspondence to Jennifer Theis.

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Theis, J., Gerdhem, P. & Abbott, A. Quality of life outcomes in surgically treated adult scoliosis patients: a systematic review. Eur Spine J 24, 1343–1355 (2015).

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