Patients with ASD treated operatively saw pain, disability improvements

SAN FRANCISCO — A paper presented in a “Best Paper” session at the North American Spine Society Annual Meeting, here, suggested operative treatment for symptomatic adult spinal deformity, which includes such conditions as scoliosis and kyphosis, can provide significantly more improvement in health-related quality of life than nonoperative treatments.

“In this series, patients who elected for operative treatment tended to have less deformity, less pain and less disability,” Justin S. Smith, MD, PhD, who presented the results for the International Spine Study Group (ISSG), said at the meeting. “Operative treated provided for these patients the opportunity for significant improvement in their health-related quality of life. In contrast, nonoperative treatment appeared to, at best, maintain presenting levels of pain and disability.”

In the study, Smith and colleagues reviewed a database to examine the 2-year outcomes for patients with adult spinal deformity (ASD), among whom 286 patients received operative treatment and 403 patients received nonoperative treatment.

The propensity-matched analysis of 97 pairs of patients with ASD showed that, for many of the measures used in the study, nonoperative care offered no improvement, according to Smith. This was the case for disability as measured by the Oswestry Disability Index, as well as for back and leg pain, among others, he said.

“Operative treatment did provide very significant improvement in leg pain. They were similar at baseline, and less leg pain [was seen] in the operative treatment group at 2-year follow-up,” he said.

“This is a timely and useful study because our aging population will be facing more symptomatic spinal degeneration and deformity than ever,” meeting program chair Charles Reitman, MD, said in a press release from the North American Spine Society. “However, as technology and surgical expertise continue to grow, it is critical that additional research be done to insure understanding of appropriate surgical indications so that utilization of surgery, as well as outcomes, for these patients may be optimized.” — by Susan M. Rapp

Reference:

Smith JS. Paper #1. Presented at: North American Spine Society Annual Meeting. Nov. 12-15, 2014; San Francisco.

Disclosure: Reitman has no relevant financial disclosures. Smith is a consultant to Biomet and has speaking and/or teaching arrangements with Biomet, AOSpine North America and Globus.