Orthopedic disease burden in adult patients with symptomatic lumbar scoliosis: results from a prospective multicenter study

作者：Justin S. Smith, Christopher I. Shaffrey, Christine R. Baldus, Michael P. Kelly, Elizabeth L. Yanik, Jon D. Lurie, Christopher P. Ames, Shay Bess, Frank Schwab, Keith H. Bridwell · 发表于：Journal of Neurosurgery Spine · 年份：2021 · DOI：10.3171/2021.1.spine201911 · 被引用次数：6 · 研究领域：Scoliosis diagnosis and treatment、Spine and Intervertebral Disc Pathology、Spinal Fractures and Fixation Techniques

OBJECTIVE: Although the health impact of adult symptomatic lumbar scoliosis (ASLS) is substantial, these patients often have other orthopedic problems that have not been previously quantified. The objective of this study was to assess disease burden of other orthopedic conditions in patients with ASLS based on a retrospective review of a prospective multicenter cohort. METHODS: The ASLS-1 study is an NIH-sponsored prospective multicenter study designed to assess operative versus nonoperative treatment for ASLS. Patients were 40-80 years old with ASLS, defined as a lumbar coronal Cobb angle ≥ 30° and Oswestry Disability Index ≥ 20, or Scoliosis Research Society-22 questionnaire score ≤ 4.0 in pain, function, and/or self-image domains. Nonthoracolumbar orthopedic events, defined as fractures and other orthopedic conditions receiving surgical treatment, were assessed from enrollment to the 4-year follow-up. RESULTS: Two hundred eighty-six patients (mean age 60.3 years, 90% women) were enrolled, with 173 operative and 113 nonoperative patients, and 81% with 4-year follow-up data. At a mean (± SD) follow-up of 3.8 ± 0.9 years, 104 nonthoracolumbar orthopedic events were reported, affecting 69 patients (24.1%). The most common events were arthroplasty (n = 38), fracture (n = 25), joint ligament/cartilage repair (n = 13), and cervical decompression/fusion (n = 7). Based on the final adjusted model, patients with a nonthoracolumbar orthopedic event were older (HR 1.44 per decade, 95%...