2022 Volume 13 Issue 11 Pages 1217-1222
Introduction: In previous studies, several researchers have demonstrated nonoperative studies of degenerative lumbar scoliosis. However, only a few studies about severe adult spinal deformity (ASD) have been demonstrated. This study aimed to investigate the outcome of natural history and conservative treatment in patients with severe ASD.
Methods: We retrospectively reviewed 27 consecutive nonoperative severe ASD patients (mean age 71.7 years, 21 women, mean follow-up 5.4±2.4 years) with a minimum of two years of follow-up. Severe ASD was defined according to Schwab as follows; Cobb > 30° or PI-LL > 20°, SVA > 9.5 cm, PT > 30°. We examined ODI, VAS, JOABPEQ as clinical outcomes and Cobb angle, Lateral spondylolisthesis, TK, LL, PI, PT, SS, TPA, SVA, CVA as radiographic parameters at baseline and last. Moreover we examined non-type N group (Cobb ≥ 30°) and non-Type N (Cobb < 30°).
Results: The average Cobb angle progressed from 33° to 42° (1.6°/year). In clinical outcomes, the degree of pains (baseline/last; 28.8 mm/38.9 mm, p = 0.03) and numbness (23.9 mm/38.0 mm, p = 0.02) in buttocks and lower limbs were significantly increased. Walking ability and mental health in JOABPEQ were as follows; 47.3/38.9, p = 0.01, 2.3/45.0, p = 0.01. In radiographic parameter, TPA (30.5°/34.5°, p = 0.01) and SVA (82.9 mm/120 mm. p = 0.01) were significantly increased. In the non-type N group, the average Cobb angle progressed from 38° to 51° (2.4°/year) and the degree of pains and numbness in buttocks and lower limb and lateral spondylolisthesis were significantly increased as follows; 34.2 mm/45.2 mm, p = 0.02, 23.9 mm/40.3 mm, p = 0.02, 6.4 mm/8.9 mm, p < 0.01).
Conclusions: Despite radiographic parameters were worse, clinical outcomes were not worse in severe ASD patient with 5 years.
