Operative Versus Nonoperative Treatment for Adult Symptomatic Lumbar Scoliosis

The Journal of Bone and Joint Surgery. American Volume
Michael P KellyKeith H Bridwell

Abstract

The effectiveness of operative compared with nonoperative treatment at initial presentation (no prior fusion) for adult lumbar scoliosis has not, to our knowledge, been evaluated in controlled trials. The goals of this study were to evaluate the effects of operative and nonoperative treatment and to assess the benefits of these treatments to help treating physicians determine whether patients are better managed operatively or nonoperatively. Patients with adult symptomatic lumbar scoliosis (aged 40 to 80 years, with a coronal Cobb angle measurement of ≥30° and an Oswestry Disability Index [ODI] score of ≥20 or Scoliosis Research Society [SRS]-22 score of ≤4.0) from 9 North American centers were enrolled in concurrent randomized or observational cohorts to evaluate operative versus nonoperative treatment. The primary outcomes were differences in the mean change from baseline in the SRS-22 subscore and ODI at 2-year follow-up. For the randomized cohort, the initial sample-size calculation estimated that 41 patients per group (82 total) would provide 80% power with alpha equal to 0.05, anticipating 10% loss to follow-up and 20% nonadherence in the nonoperative arm. However, an interim sample-size calculation estimated that 18 pati...Continue Reading

References

Feb 20, 2003·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·O HäggUNKNOWN Swedish Lumbar Spine Study Group
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Feb 2, 2010·Spine·Steven D GlassmanKeith H Bridwell
Nov 19, 2013·Journal of Comparative Effectiveness Research·Jon D Lurie, Tamara S Morgan
Dec 10, 2013·The Spine Journal : Official Journal of the North American Spine Society·Ian M McCarthyUNKNOWN International Spine Study Group
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Aug 16, 2016·The New England Journal of Medicine·Ian Ford, John Norrie

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Citations

Apr 21, 2020·The Journal of Bone and Joint Surgery. American Volume·Jacob M Buchowski, Owoicho Adogwa
Oct 18, 2019·Neurosurgery·Michael M SafaeeJustin S Smith
Jun 4, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Adam M WegnerMichael P Kelly
Feb 10, 2021·Global Spine Journal·Scott L ZuckermanUNKNOWN AO Spine Knowledge Forum Deformity and SRS Scoli-RISK-1 Study Group
Feb 21, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jonathan Charles ElyseeVirginie Lafage
Apr 15, 2020·The Spine Journal : Official Journal of the North American Spine Society·Yoji OguraUNKNOWN International Spine Study Group (ISSG)
Mar 19, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Kiyotaka YamadaYoshinori Fujimoto
Sep 26, 2020·Global Spine Journal·Jonathan Charles ElyseeVirginie Lafage
Apr 7, 2021·Spine Deformity·Marinus de KleuverUNKNOWN COSSCO study group
Mar 29, 2021·World Neurosurgery·Masato TanakaTaro Yamauchi
Jul 11, 2020·Journal of Neurosurgery. Spine·Thomas J Buell, Justin S Smith
Sep 11, 2021·Journal of Neurosurgery. Spine·Francis LovecchioHan Jo Kim
Oct 2, 2021·Journal of Neurosurgery. Spine·Ferran PelliséUNKNOWN International Spine Study Group (ISSG) and European Spine Study Group (ESSG)
Jun 30, 2021·Clinical Spine Surgery : a Spine Publication·Kunal VarshneyaAnand Veeravagu
Jan 29, 2022·Spine Deformity·Paul InclanMichael P Kelly

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