OBJECTIVE: Treatment decision making in elderly patients with degenerative scoliosis is complex. Although most patients can be adequately treated with nonoperative therapies, a subset ultimately elects for surgical treatment. However, the factors that govern this transition are poorly understood. The objective of this study was to assess whether standardized measures of health status and disability may be useful in distinguishing those patients who elect for surgical treatment. METHODS: This study is a retrospective review of a prospective database of 139 consecutive patients aged older than 60 years (mean = 70 years), with degenerative scoliosis treated by a single surgeon. Patients with severe symptoms who had failed multimodality nonoperative care were considered for surgical intervention. The Scoliosis Research Society Questionnaire (SRS-30), 12-Item Short Form Health Survey (SF-12), Oswestry Disability Index (ODI) surveys, and Charlson Comorbidity Index (CCI) were collected at the time of presentation and compared between the operative and nonoperative groups. RESULTS: There were no statistically significant differences between the operative and nonoperative groups in terms of age and major radiographic parameters. Significant differences between the operative and nonoperative groups were found for all 3 self-assessment survey results, with those electing for operative intervention reporting worse scores for ODI (54 versus 40; P = .001), SRS-30 (2.7 versus 3.0; P = .01), SF-12 physical component summary (23 versus 29; P = .01), and SF-12 mental component summary (46 versus 52; P = .03). Unexpectedly, patients treated surgically had a higher level of comorbidity as measured by the CCI (2.0 versus 1.3; P = .003). CONCLUSION: Self-assessments of health and disability distinguish elderly patients with degenerative scoliosis electing for surgery compared with those who continue nonoperative therapies. Standardized measures of health status and disability may be useful in identifying patients nearing the threshold of crossing over to surgical treatment.
OBJECTIVE: Treatment decision making in elderly patients with degenerative scoliosis is complex. Although most patients can be adequately treated with nonoperative therapies, a subset ultimately elects for surgical treatment. However, the factors that govern this transition are poorly understood. The objective of this study was to assess whether standardized measures of health status and disability may be useful in distinguishing those patients who elect for surgical treatment. METHODS: This study is a retrospective review of a prospective database of 139 consecutive patients aged older than 60 years (mean = 70 years), with degenerative scoliosis treated by a single surgeon. Patients with severe symptoms who had failed multimodality nonoperative care were considered for surgical intervention. The Scoliosis Research Society Questionnaire (SRS-30), 12-Item Short Form Health Survey (SF-12), Oswestry Disability Index (ODI) surveys, and Charlson Comorbidity Index (CCI) were collected at the time of presentation and compared between the operative and nonoperative groups. RESULTS: There were no statistically significant differences between the operative and nonoperative groups in terms of age and major radiographic parameters. Significant differences between the operative and nonoperative groups were found for all 3 self-assessment survey results, with those electing for operative intervention reporting worse scores for ODI (54 versus 40; P = .001), SRS-30 (2.7 versus 3.0; P = .01), SF-12 physical component summary (23 versus 29; P = .01), and SF-12 mental component summary (46 versus 52; P = .03). Unexpectedly, patients treated surgically had a higher level of comorbidity as measured by the CCI (2.0 versus 1.3; P = .003). CONCLUSION: Self-assessments of health and disability distinguish elderly patients with degenerative scoliosis electing for surgery compared with those who continue nonoperative therapies. Standardized measures of health status and disability may be useful in identifying patients nearing the threshold of crossing over to surgical treatment.
Authors: Frank J Schwab; Nicola Hawkinson; Virginie Lafage; Justin S Smith; Robert Hart; Gregory Mundis; Douglas C Burton; Breton Line; Behrooz Akbarnia; Oheneba Boachie-Adjei; Richard Hostin; Christopher I Shaffrey; Vincent Arlet; Kirkham Wood; Munish Gupta; Shay Bess; Praveen V Mummaneni Journal: Eur Spine J Date: 2012-05-17 Impact factor: 3.134
Authors: S Richner-Wunderlin; A F Mannion; A Vila-Casademunt; F Pellise; M Serra-Burriel; B Seifert; E Aghayev; E Acaroglu; A Alanay; F J S Pérez-Grueso; I Obeid; F Kleinstück Journal: Eur Spine J Date: 2018-09-14 Impact factor: 3.134
Authors: Takashi Fujishiro; Louis Boissière; Derek Thomas Cawley; Daniel Larrieu; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre Acaroglu; Ahmet Alanay; Ibrahim Obeid Journal: Eur Spine J Date: 2019-03-07 Impact factor: 3.134
Authors: Takashi Fujishiro; Louis Boissière; Derek Thomas Cawley; Daniel Larrieu; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre Acaroglu; Ahmet Alanay; Ibrahim Obeid Journal: Eur Spine J Date: 2019-07-17 Impact factor: 3.134
Authors: Justin S Smith; Christopher I Shaffrey; Steven D Glassman; Leah Y Carreon; Frank J Schwab; Virginie Lafage; Vincent Arlet; Kai-Ming G Fu; Keith H Bridwell Journal: Eur Spine J Date: 2012-10-18 Impact factor: 3.134
Authors: Takashi Fujishiro; Louis Boissière; Derek Thomas Cawley; Daniel Larrieu; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre Acaroglu; Ahmet Alanay; Ibrahim Obeid Journal: Eur Spine J Date: 2018-03-30 Impact factor: 3.134
Authors: Selim Ayhan; Selcen Yuksel; Vugar Nabiyev; Prashant Adhikari; Alba Villa-Casademunt; Ferran Pellise; Francisco Sanchez Perez-Grueso; Ahmet Alanay; Ibrahim Obeid; Frank Kleinstueck; Emre Acaroglu Journal: Global Spine J Date: 2018-04-29