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Comparable patient satisfaction after decompression or fusion for lumbar degenerative scoliosis

Issue: Issue 4 2012

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AMSTERDAM — Among adult patients with lumbar degenerative scoliosis in the European Spine Tango Registry who were treated with decompression, fusion or a combination of the procedures, Swiss investigators reported no significant differences in patient satisfaction at a minimum 12-month follow-up.

“All patient groups benefitted from the treatment as demonstrated in the [core outcome measurement instrument] COMI outcome. There was a significant change of more than 50% above baseline in all three different groups, with no difference between the groups,” Frank S. Kleinstück, MD, said at SpineWeek 2012, here.

Frank S. Kleinstuck

The investigation also revealed no differences in clinical outcomes for these procedures, according to Kleinstück, of the Schulthess Klinik in Zurich.

Six spine surgeons at the clinic performed decompression alone in 84 patients with stenotic symptoms; short 1-level or 2-level fusion in 54 patients; and a longer fusion of three or more levels in 38 patients to correct lost spinal balance or progressive collapse, or decompression combined with fusion.

Patients with a history of idiopathic scoliosis were excluded. There were slightly more women than men in the study. The decompression group was significantly older than both fusion groups and had more comorbidities.

“As a trend, fusion groups, especially the short fusion group, benefitted more from the surgery than the decompression groups, however, the complication rate did not differ,” Kleinstück said.

When study participants rated their global outcomes as good or poor using a Likert scale, the results were a “good” global outcome in 68% of decompression patients “whereas with fusion – shorter [was] better than longer fusion,” he said.

Global outcome was rated as good in 81% of short fusion patients and 76% of long fusion patients. The investigators wrote in the abstract that patient satisfaction results were similar to data reported in other lumbar procedures.

Reference:

• Kleinstück FS, Buddenberg P, Fekete TF, et al. The outcome of surgery for lumbar degenerative scoliosis: What does the patient think? Paper #75. Presented at SpineWeek 2012. May 28-June 1. Amsterdam.
• Disclosure: Kleinstück has no relevant financial disclosures.