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Teles AR, Mattei TA, Righesso O, et al. Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature. Global Spine J. 2017;7(2):170-178doi: 10.1177/2192568217699182.
Teles, A. R., Mattei, T. A., Righesso, O., & Falavigna, A. (2017). Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature. Global spine journal, 7(2), 170-178. https://doi.org/10.1177/2192568217699182
Teles, Alisson R, et al. "Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature." Global spine journal vol. 7,2 (2017): 170-178. doi: https://doi.org/10.1177/2192568217699182
Teles AR, Mattei TA, Righesso O, Falavigna A. Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature. Global Spine J. 2017 Apr;7(2):170-178. doi: 10.1177/2192568217699182. Epub 2017 May 01. PMID: 28507887; PMCID: PMC5415160.
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Global Spine J. 2017 Apr;7(2):170-178. doi: 10.1177/2192568217699182. Epub 2017 May 01.

Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature.

Global spine journal

Alisson R Teles, Tobias A Mattei, Orlando Righesso, Asdrubal Falavigna

Affiliations

  1. Department of Clinical Neurosciences - Neurosurgery, University of Calgary, Calgary, Alberta, Canada.
  2. Neurosurgery & Spine Specialists, Eastern Maine Medical Center, Bangor, Maine, USA.
  3. Department of Orthopedics, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.
  4. Department of Neurosurgery, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.

PMID: 28507887 PMCID: PMC5415160 DOI: 10.1177/2192568217699182

Abstract

STUDY DESIGN: Systematic review.

OBJECTIVE: There is a need for synthesizing data on effectiveness of treatments for patients with adult spinal deformity (ASD) due to its increasing prevalence and health care costs for these patients. The objective of this review was to estimate the effectiveness of surgery versus nonoperative care in patients with ASD.

METHODS: A systematic review of articles in published in English using PubMed between 2005 and 2015. Surgical and nonsurgical series that reported baseline and follow-up health-related quality of life measures of patients with ASD with a minimum 2 years of follow-up were selected. Independent extraction of articles by 2 authors using predefined data fields, including risk of bias assessment.

RESULTS: Surgery significantly reduces disability, pain, and improves patients' quality of life. The average postoperative improvement in Oswestry Disability Index was -19.1 (±9.0), Numerical Rating Scale back pain -4.14 (±1.38), Numerical Rating Scale leg pain -3.36 (±1.33), Short-Form Health Survey 36-SF36-Physical Component score 11.2 (±5.07), and Short-Form Health Survey 36-Mental Component score 9.93 (±4.96). The complication rate ranged from 9.52% to 81.52% (mean = 39.62%), and the need for revision surgery ranged from 1.72% to 40.0% (mean = 15.71%). The best existing evidence about nonoperative care of ASD is provided from observational studies with very high risk of bias. Quantitative analyses of nonsurgical cohorts did not demonstrate significant changes in quality of life of patients after 2 years of observation.

CONCLUSIONS: This data may assist clinicians to counsel patients, as well as to inform health care providers and policymakers about what to expect from the treatment for ASD.

Keywords: adult; quality of life; scoliosis; surgery; systematic review

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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