Operative vs Nonoperative Treatment for Adult Symptomatic Lumbar Scoliosis at 8-Year Follow-Up

作者：Justin S. Smith, Michael P. Kelly, Elizabeth L. Yanik, Christine R. Baldus, Vy Pham, David Ben‐Israel, Jon D. Lurie, Charles C. Edwards, Steven D. Glassman, Lawrence G. Lenke, Jacob M. Buchowski, Leah Y. Carreon, Charles H. Crawford, Stephen J. Lewis, Tyler R. Koski, Virginie Lafage, Munish Kumar Gupta, Han Jo Kim, Christopher P. Ames, Shay Bess, Frank Schwab, Christopher I. Shaffrey, Keith H. Bridwell · 发表于：JAMA Surgery · 年份：2025 · DOI：10.1001/jamasurg.2025.0496 · 被引用次数：18 · 研究领域：Scoliosis diagnosis and treatment、Spine and Intervertebral Disc Pathology、Spinal Fractures and Fixation Techniques

Importance: Long-term follow-up studies of operative and nonoperative treatment of adult symptomatic lumbar scoliosis (ASLS) are needed to assess benefits and durability. Objective: To assess the durability of treatment outcomes for operative vs nonoperative treatment of ASLS. Design, Setting, and Participants: The Adult Symptomatic Lumbar Scoliosis 1 (ASLS-1) study was a multicenter, prospective study with randomized and observational cohorts designed to assess operative vs nonoperative ASLS treatment. Operative and nonoperative patients were compared using as-treated analysis of combined randomized and observational cohorts. Patients with ASLS aged 40 to 80 years were enrolled at 9 centers in North America. Data were analyzed from November 2023 to July 2024. Interventions: Operative and nonoperative treatment approaches. Main Outcomes and Measures: Primary outcomes measures were the Oswestry Disability Index (ODI) and Scoliosis Research Society 22 (SRS-22) at 2-, 5-, and 8-year follow-up. Results: The 286 enrolled patients (104 in the nonoperative group: median [IQR] age, 61.9 [54.4-68.8] years; 97 female [93%]; 182 in the operative group: median [IQR] age, 60.2 [53.5-66.6] years; 161 female [88%]) had follow-up rates at 2, 5, and 8 years of 90% (256 of 286), 70% (199 of 286), and 72% (205 of 286), respectively. At 2 years, compared with those in the nonoperative group, patients in the operative group had better ODI (mean difference = -12.98; 95% CI, -16.08 to -9.88; P < .0...