Tae Sik Goh1, Jong Ki Shin1, Myung Soo Youn2, Hong Seok Lee3, Taek Hoon Kim1, Jung Sub Lee4. 1. Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea. 2. Department of Orthopaedic Surgery, Myungeun Hospital, Busan, Republic of Korea. 3. Lee Hong Seok Orthopaedic Hospital, Busan, Republic of Korea. 4. Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea. jungsublee@pusan.ac.kr.
Abstract
PURPOSE: Surgery is widely performed for lumbar degenerative kyphosis (LDK), but its effectiveness as compared with nonsurgical treatment has not been demonstrated. METHODS: In this prospective study, surgical candidates with LDK were enrolled at three spine centres. Two treatment options were performed either surgery using a pedicle subtraction osteotomy or nonsurgical care. Outcomes were measured using a Visual analogue scale (VAS) of back pain as a primary endpoint, the Oswestry disability index (ODI), the 36-item short-form health survey (SF-36), sagittal vertical axis (SVA) and treatment-related complications. RESULTS: Of the 126 LDK patients treated during the reference period, 97 patients were enrolled (47 in the surgical group and 50 in the nonsurgical group). Surgical group produced statistically reduced VAS of back pain and better functional outcomes than nonsurgical group since 12 months after treatment, but the rate of serious complications was higher after surgery. Interestingly, both surgical and nonsurgical groups had improved outcomes in terms of pain intensity and function at the 2-year follow-up period. CONCLUSIONS: Surgery might be a preferred treatment option for LDK, but great caution is needed. And conservative treatment could be the considerable treatment option for LDK who is unwilling or has poor medical condition to operate.
PURPOSE: Surgery is widely performed for lumbar degenerative kyphosis (LDK), but its effectiveness as compared with nonsurgical treatment has not been demonstrated. METHODS: In this prospective study, surgical candidates with LDK were enrolled at three spine centres. Two treatment options were performed either surgery using a pedicle subtraction osteotomy or nonsurgical care. Outcomes were measured using a Visual analogue scale (VAS) of back pain as a primary endpoint, the Oswestry disability index (ODI), the 36-item short-form health survey (SF-36), sagittal vertical axis (SVA) and treatment-related complications. RESULTS: Of the 126 LDK patients treated during the reference period, 97 patients were enrolled (47 in the surgical group and 50 in the nonsurgical group). Surgical group produced statistically reduced VAS of back pain and better functional outcomes than nonsurgical group since 12 months after treatment, but the rate of serious complications was higher after surgery. Interestingly, both surgical and nonsurgical groups had improved outcomes in terms of pain intensity and function at the 2-year follow-up period. CONCLUSIONS: Surgery might be a preferred treatment option for LDK, but great caution is needed. And conservative treatment could be the considerable treatment option for LDK who is unwilling or has poor medical condition to operate.
Entities:
Keywords:
Conservative; Lumbar degenerative kyphosis; Nonsurgical; Pedicle subtraction osteotomy; Surgery
Authors: Whoan Jeang Kim; Jong Won Kang; Sung Il Kang; Hwan Il Sung; Kun Young Park; Jae Guk Park; Won Cho Kwon; Won Sik Choy Journal: Asian Spine J Date: 2010-04-26