Abstract
Study Design
Retrospective review of a prospective, multi-institutional database.
Objectives
To determine postoperative quality of life outcomes in scoliosis patients using the Oswestry Disability Index (ODI) at defined time points.
Summary of Background Data
Spinal surgery provides significant improvement in both pain and disability in adults with scoliosis compared with conservative treatment; however, the postoperative timing of improvements in quality of life outcomes has not been studied.
Methods
This was a retrospective review of a prospective, multi-center database with 1,750 patients. All patients completed the ODI at first encounter and at 6 follow-ups (6 weeks, 6 months, and 1, 2, 3, and 5 years). The authors stratified by age, primary versus revision, staged surgery, anatomical region of surgery, complexity (osteotomy and levels), and complications (intraoperative and postoperative).
Results
At baseline and most follow-up visits, older patients, those with revision surgeries, and those who had an osteotomy had significantly higher ODI scores than did young patients, those with primary surgeries, and those who did not have an osteotomy. All stratified groups showed a significant ODI score decrease between 6 weeks’ and 6 months’ follow-up. However, most of the stratified group patients’ outcomes remained unchanged throughout the postoperative recovery period from 1 to 5 years.
Conclusions
Surgical treatment has the potential to significantly improve the quality of life of patients with adult scoliosis. An understanding of the timing of improvement after surgery will improve both the counseling of surgical candidates and patient care pathways.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Richards BS, Herring JA, Johnston CE, et al. Treatment of idiopathic scoliosis using Texas Scottish Rite Hospital (TSRH) instrumentation. Spine 1994;19:1598–605.
Carreon LY, Puno RM, Dimar JR, et al. Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am 2003;85:2089–92.
Deyo RA, Cherkin DC, Loeser JD, et al. Morbidity and mortality in association with operations on the lumbar spine—the influence of age, diagnosis and procedure. J Bone Joint Surg Am 1992;74:536–43.
Cassinelli EH, Eubanks J, Vogt M, et al. Risk factors for the development of perioperative complications in elderly patients undergoing lumbar decompression and arthrodesis for spinal stenosis—An analysis of 166 patients. Spine (Phila Pa 1976) 2007;32:230–5.
Benner B, Ehni G. Degenerative lumbar scoliosis. Spine (Phila Pa 1976) 1979;4:548–52.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2940–52; discussion 2952.
Smith JS, Shaffrey CI, Berven S, et al. Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery 2009;65:86–94.
Glassman SD, Schwab FJ, Bridwell KH, et al. The selection of operative versus nonoperative treatment in patients with adult scoliosis. Spine (Phila Pa 1976) 2007;32:93–7.
Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976) 2005;30:1082–5.
Smith JS, Sansur CA, Donaldson WF, et al. Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age. Spine (Phila Pa 1976) 2011;36:958–64.
Bradford DS, Tay BK, Hu SS. Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976) 1999;24:2617–29.
Raffo CS, Lauerman WC. Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade. Spine (Phila Pa 1976) 2006;31:99–103.
Zimmerman RM, Mohamed AS, Skolasky RL, et al. Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older: a prospective study with minimum two-year follow-up. Spine (Phila Pa 1976) 2010;35:1861–6.
Smith EB, Hanigan WC. Surgical results and complications in elderly patients with benign lesions of the spinal canal. J Am Geriatr Soc 1992;40:867–70.
Schwab FJ, Lafage V, Farcy J, et al. Predicting outcome and complications in the surgical treatment of adult scoliosis. Spine (Phila Pa 1976) 2008;33:2243–7.
Sansur CA, Smith JS, Coe JD, et al. Scoliosis Research Society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976) 2011;36:E593–7.
Bridwell KH, Lewis SJ, Edwards C, et al. Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine (Phila Pa 1976) 2003;28:2093–101.
Master DL, Son Hing JP, Poe Kochert C, et al. Risk factors for major complications after surgery for neuromuscular scoliosis. Spine (Phila Pa 1976) 2011;36:564–71.
Weiss H. Adolescent idiopathic scoliosis (AIS)—an indication for surgery? A systematic review of the literature. Disabil Rehabil 2008;30:799–807.
Smith A, Juraskova I, Butow P, et al. Sharing vs. caring—The relative impact of sharing decisions versus managing emotions on patient outcomes. Patient Educ Couns 2011;82:233–9.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
Author disclosures: MHW (none); JEM (none); SKT (none); LHN (none); SB (none).
Rights and permissions
About this article
Cite this article
Weber, M.H., Mathew, J.E., Takemoto, S.K. et al. Postoperative Recovery Outcomes in Adult Scoliosis: A Prospective Multicenter Database With 5-Year Follow-Up. Spine Deform 2, 226–232 (2014). https://doi.org/10.1016/j.jspd.2014.01.001
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.jspd.2014.01.001