The factors that play a role in the decision-making process of adult deformity patients.

STUDY
DESIGN: Retrospective matched cohort.
OBJECTIVE: To investigate the factors that may affect the decision-making process of adult deformity patients. SUMMARY OF BACKGROUND DATA: Adult deformity is a significant cause of morbidity in the elderly population. Despite high complication rates a significant number of patients still prefer operative treatment. Analysis of the factors that drive these patients to operative treatment would help surgeons to better evaluate these patients.
METHODS: Adult deformity patients who are evaluated in a single institute were reviewed. The inclusion criteria were being >18 years old, having a coronal curve magnitude of >30 degrees , having no previous surgery or associated neuromuscular or inflammatory condition, having completed SF-12, SRS-30, and Oswestry Disability Index questionnaires in the initial visit, and having a complete set of radiographs. The demographic data as well as back and leg pain incidences and magnitudes were collected. The eligible patients were compared first as age-gender-curve type matched cohorts.
RESULTS: Functional domain scores particularly walking in Oswestry Disability Index and vitality in the SRS-30 were significantly worse in the operative treatment group, whereas the pain scores were similar in both groups in all outcomes assessment questionnaires. Besides, there was no difference among 2 groups with respect to either the incidence or the magnitude of back or leg pain.
CONCLUSION: These results suggest that functional limitations are more important than pain for adult deformity patients when deciding for operative or nonoperative treatment.