Postoperative Recovery Outcomes in Adult Scoliosis: A Prospective Multicenter Database With 5-Year Follow-Up.

Abstract

Retrospective review of a prospective, multi-institutional database. To determine postoperative quality of life outcomes in scoliosis patients using the Oswestry Disability Index (ODI) at defined time points. Spinal surgery provides significant improvement in both pain and disability in adults with scoliosis compared with conservative treatment; however, the postoperative timing of improvements in quality of life outcomes has not been studied. This was a retrospective review of a prospective, multi-center database with 1,750 patients. All patients completed the ODI at first encounter and at 6 follow-ups (6 weeks, 6 months, and 1, 2, 3, and 5 years). The authors stratified by age, primary versus revision, staged surgery, anatomical region of surgery, complexity (osteotomy and levels), and complications (intraoperative and postoperative). At baseline and most follow-up visits, older patients, those with revision surgeries, and those who had an osteotomy had significantly higher ODI scores than did young patients, those with primary surgeries, and those who did not have an osteotomy. All stratified groups showed a significant ODI score decrease between 6 weeks' and 6 months' follow-up. However, most of the stratified group patients' outcomes remained unchanged throughout the postoperative recovery period from 1 to 5 years. Surgical treatment has the potential to significantly improve the quality of life of patients with adult scoliosis. An understanding of the timing of improvement after surgery will improve both the counseling of surgical candidates and patient care pathways.