Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series

Abstract

Purpose The surgical approach to adult spine deformities is complex and presents a high incidence of complications. Methods We report here a prospective consecutive case series analysis of 20 patients submitted to posterior correction and instrumented fusion for adult degenerative scoliosis. Clinical outcomes were assessed by self-reported measures. Pre-operative and post-operative complications were analysed during a mean 30-month follow-up period. Results Eleven patients (55 %) presented pre-operative or post-operative complications. Fifteen different complications occurred, six in the early pre-operative period and nine during follow-up period: ten of these complications occurred in patients who underwent a previous surgery for spine disease. Conclusions The clinical improvement at the final follow-up resulted as statistically significant only for the group of patients exposed to posterior fusion without interbody fusion. The observations reported here have to be considered for a shared decision-making in the management of adult scoliosis.

TLIF by Wiltse Approach versus OLIF for degenerative lumbar scoliosis: A retrospective study

“…Therefore, the restoration of sagittal balance is particularly important during surgical treatment of ADS. In the evaluation of postoperative imaging of patients, we can see that the coronal Cobb angle, LL, and LL-PI of the two groups have been signi cantly improved after the operation and and the correction result was similar to that reported in previous studies involving traditional open procedures [22][23][24] . However, the average improvement of the Cobb angle in the OLIF group was greater than that of Wilste-TLIF, indicating that OLIF has a better correction effect on LL.…”

Pain and Radiographic Outcomes in Adult Idiopathic Scoliosis Patients Using a Scoliosis Activity Suit: An 18-Month Case Controlled Chart Review

“…Most of the treatment studies in adults with idiopathic scoliosis have been surgical. However, common among the various surgical techniques is the incidence of perioperative and postoperative complications, ranging from 17% -55% [7]- [9]. The chance of revision surgery in a study of 306 patients was 44% in the first 6 years [10].…”