Extreme long-term outcome of operatively versus conservatively treated patients with adolescent idiopathic scoliosis

Farshad, Mazda; Kutschke, Lucas; Laux, Christoph J.; Kabelitz, Method; Schüpbach, Regula; Böni, Thomas; Jentzsch, Thorsten

doi:10.1007/s00586-020-06509-1

Cited by 7 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 107 subjects, no significant difference was verified concerning ODI and three out of four domains (pain, function, mental health) of the SRS-22 questionnaire compared to a control group. Such and other reports, including our current report, raise the question whether differences of treatment options are clinically less relevant than expected or if the measures that are used to find clinically relevant differences are not adequate enough [ 28 ]. Although it is known that younger patients with AIS may develop greater deformities with potentially more severe secondary degenerative changes, we did not find an association of age at diagnosis with long-term poor back function ( p = 0.771) in our collective [ 29 ].…”

Section: Discussionmentioning

confidence: 95%

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years

et al. 2022

Self Cite

View full text Add to dashboard Cite

Purpose Adolescent idiopathic scoliosis (AIS) affects up to 3% of otherwise healthy adolescents. The extreme long-term outcomes of nonoperative treatment are underreported. This study aimed to investigate the long-term outcome of nonoperative-treated AIS patients. Comparison between a bracing and an observation approach were performed. Methods In a retrospective cohort study, 20 nonoperatively treated AIS patients were observed concerning patient-related outcome measures (PROM) (visual analog scale (VAS), Short Form Health Survey 36 item (SF 36), Scoliosis Research Society (SRS 24), Oswestry Low Back Pain Disability Index (ODI), Psychological General Well-Being Index (PGWBI)), radiological curve progression and health-related quality of life (HRQoL). Baseline characteristics and radiological imaging were collected. At follow-up, anteroposterior and lateral X-rays as well as questionnaires were analyzed. Results Twenty patients (16 females, mean age: 14.6 ± 3.2 years) with a follow-up time of 42 ± 9 years were included. Nine patients (initial Cobb 35° ± 19°) were treated with bracing for a mean time of 26 ± 9 months, while the other 11 patients (initial Cobb 29° ± 11°) were observed. The primary curve progressed from 32° ± 15° to 52° ± 25° in average with no significant difference between the cohorts (p = 0.371). At final follow-up, a mean ODI score of 7 ± 7.9 points with no difference depending on the treatment (p = 0.668) was seen. No significant differences were observed for PROMs. Curve magnitude correlated neither at diagnosis (p = 0.617) nor at follow-up (p = 0.535) with the ODI score at final follow-up. Conclusion After a mean of 42 years, patients with nonoperative treatment of moderate AIS demonstrated a good clinical outcome despite progression of the deformity. Level of evidence Level IV, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 95%

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recent studies have shown that magnetic resonance imaging (MRI) and CT are more reliable tools for evaluating certain spinal sagittal parameters [32]. And researchers such as Jentzsch et al [33]. and Lee et al [34] have used CT scans to accurately determine spinal sagittal balance values.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Pelvic Sacral Angle as an indicator for spinopelvic balance: A radiographic review of 56 individuals in standing and supine positions

Qi,

zhang,

xue

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Over the past decade, the sagittal balance of the spine has garnered significant attention from surgeons. The compensatory mechanism of the pelvis plays a crucial role in maintaining the sagittal balance of the whole body. Several methods have been reported for reconstructing spinal sagittal balance based on pelvic parameters. However, controversy persists over restoring appropriate lumbar lordosis in spinal surgery. The purpose of this study is to investigate the role of PSA and APPA in assessing pelvic position and their correlation with spinopelvic parameters. Methods All patients underwent EOS and CT scans in both standing and supine positions to evaluate alterations in spinal sagittal balance parameters between the two postures. Measurements were taken for lumbar lordosis, thoracic kyphosis, sacral slope, pelvic incidence, pelvic tilt, pelvic sacral angle, and anterior pelvis plane angle. Changes and correlations in sagittal balance parameters in the spinal-pelvic region between the two postures were compared and analyzed. Results Statistically significant differences were found between the two groups for pelvic tilt (PT) (p < 0.05). The supine position showed a significantly higher mean value for pelvic sacral angle (PSA) (p = 0.005) compared to the standing position. Similarly, the supine position exhibited a significantly lower mean value for anterior pelvis plane angle (APPA) (p = 0.001) compared to the standing position. Strong correlations were observed between PSA and other spinopelvic parameters, particularly PT, pelvic inclination (PI), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), and APPA in both the supine and standing groups. Additionally, a strong correlation was found between APPA and pelvic parameters, especially PI. Conclusion The PSA and spinopelvic parameters showed a significant correlation. Our findings suggest that the PSA and APPA can be valuable parameters for assessing spinopelvic balance, particularly in cases involving pelvic rotation. Additionally, the spinal and pelvic parameters obtained in the supine position may offer greater reliability.

show abstract

“…Considering the rising numbers of long spinal fusions (Beschloss et al 2021 ) and the obvious lack of evidence only few surgeons seem to tell their patients that with respect to health, there is no huge advantage of surgery when compared to non-surgical management (Ward et al 2017 ). Indeed, Farshad et al ( 2020 ) in their article conclude ‘After around 47 and 39 years, respectively, surgical and non-surgical treatment of moderate AIS showed similar subjective outcomes, but with a relevant smaller curve magnitude with surgical treatment’.…”

Section: Discussionmentioning

confidence: 99%

Is there an indication for surgery in patients with spinal deformities? – A critical appraisal

Weiss¹,

Nan²,

Potts

2021

South African Journal of Physiotherapy

View full text Add to dashboard Cite

Background: High-quality evidence exists to support physiotherapy and brace treatment for scoliosis and other spinal deformities. However, according to previous systematic reviews, it seems that no evidence exists for surgery. Nevertheless, the number of research articles focussing on spinal surgery highly exceeds the number of articles focussing on conservative treatment.Objective: The purpose of this study is to conduct an updated search for systematic reviews providing high-quality evidence for spinal surgery in patients with spinal deformities.Method: A narrative review including PubMed and the Cochrane database was conducted on April 12, 2020, with the following search terms: (1) spinal deformities, surgery, systematic review and outcome; (2) kyphosis, surgery, systematic review and outcome; (3) Scheuermann’s disease, surgery, systematic review and outcome, and (4) scoliosis, surgery, systematic review and outcome.Results: No reviews containing prospective controlled or randomised controlled studies were found providing evidence for surgery.Conclusions: A general indication for spine surgery just based on the Cobb angle is not given. In view of the long-term unknown variables and the possible long-term complications of such treatment, a surgical indication for patients with spinal deformities must be reviewed on an individual basis and considered carefully. A current systematic review appears necessary in order to be able to draw final conclusions on the indication for surgery in patients with spinal deformities.Clinical implications: In view of the increasing number of surgeons with an affiliation to industry, the indication for surgery needs to be given by independent conservative specialists for spinal deformities in order to provide an objective recommendation.

show abstract

Extreme long-term outcome of operatively versus conservatively treated patients with adolescent idiopathic scoliosis

Cited by 7 publications

References 23 publications

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years

Evaluation of Pelvic Sacral Angle as an indicator for spinopelvic balance: A radiographic review of 56 individuals in standing and supine positions

Is there an indication for surgery in patients with spinal deformities? – A critical appraisal

Contact Info

Product

Resources

About