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Optimal Care for Adults with Scoliosis

There is a wide range of spinal deformities leading to disability in the adult population. In particular, adults with scoliosis are the focus of this study. Scoliosis is an abnormal curvature of the spine.

A classification system was previously developed to group patients with spinal deformities. This adult spinal deformity classification system was used to provide a common language for talking about this condition. Patients were grouped according to the level of their disability, pain, and the impact of the condition.

The researchers were looking for treatment patterns and surgical strategies based on the type and location of spinal deformity. X-rays were used to place patients in groups. The hope was to find treatment guidelines to help doctors manage these complex disorders.

The classification method used has already been proven reliable. Past studies show that the patient classification is linked with disability. The next step is to see what affect classification has on surgical outcomes. For example, can the clinical impact of the condition help guide the surgeon in choosing the best procedure?

The authors found that the rate of surgery increased in patients with the greatest spinal imbalance and deformity. Specific descriptors in the classification were also linked with the type of surgery done.

For example, fusion and surgical approach (from the front, side, back, or combination of directions) could be predicted based on the patient's classification group. Likewise, patients with decreased lumbar lordosis (natural curve of the lower spine) were more likely to need a more aggressive operation to achieve realignment.

Other patterns were also observed. Patients with no lordosis were the most disabled before surgery. They also had the most improvement and least disability at the end of one-year.

Although the authors found some patterns in the results and effect of surgical approaches, they state that larger studies with further analysis are needed. This study was just the start in understanding what constitutes optimal care for adults with spinal deformity such as scoliosis.


Frank Schwab, MD, et al. Surgical Rates and Operative Outcome Analysis in Thoracolumbar and Lumbar Major Adult Scoliosis. In Spine. November 15, 2007. Vol. 32. No. 24. Pp. 2723-2730.

11/21/2007

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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