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Spine (Phila Pa 1976). 2009 Apr 15;34(8):813-7. doi: 10.1097/BRS.0b013e3181851ba6.

The factors that play a role in the decision-making process of adult deformity patients.

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1
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA 94143, USA.

Abstract

STUDY DESIGN:

Retrospective matched cohort.

OBJECTIVE:

To investigate the factors that may affect the decision-making process of adult deformity patients.

SUMMARY OF BACKGROUND DATA:

Adult deformity is a significant cause of morbidity in the elderly population. Despite high complication rates a significant number of patients still prefer operative treatment. Analysis of the factors that drive these patients to operative treatment would help surgeons to better evaluate these patients.

METHODS:

Adult deformity patients who are evaluated in a single institute were reviewed. The inclusion criteria were being >18 years old, having a coronal curve magnitude of >30 degrees , having no previous surgery or associated neuromuscular or inflammatory condition, having completed SF-12, SRS-30, and Oswestry Disability Index questionnaires in the initial visit, and having a complete set of radiographs. The demographic data as well as back and leg pain incidences and magnitudes were collected. The eligible patients were compared first as age-gender-curve type matched cohorts.

RESULTS:

Functional domain scores particularly walking in Oswestry Disability Index and vitality in the SRS-30 were significantly worse in the operative treatment group, whereas the pain scores were similar in both groups in all outcomes assessment questionnaires. Besides, there was no difference among 2 groups with respect to either the incidence or the magnitude of back or leg pain.

CONCLUSION:

These results suggest that functional limitations are more important than pain for adult deformity patients when deciding for operative or nonoperative treatment.

PMID:
19365250
DOI:
10.1097/BRS.0b013e3181851ba6
[Indexed for MEDLINE]
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