Differences in Functional Treadmill Tests in Patients with Adult Symptomatic Lumbar Scoliosis Treated Operatively and Non-operatively at a Minimum Five-Year Follow-up.

Abstract

Prospective Longitudinal Cohort. To present the long-term Functional Treadmill Test (FTT) results in patients with Adult Symptomatic Lumbar Scoliosis (ASLS) treated operatively (Op) and non-operatively (Non-Op). A previous study on this cohort showed that at two years after intervention, FTT time ambulated deteriorated in Non-Op patients but improved in Op patients. Post-FTT back and leg pain improved in both groups with greater gains in the Op group. 168 (62%) of 272 surviving subjects who underwent Operative (Op, N=115) or Non-operative treatment (N=53) were included with mean follow-up 7.49 ± 1.61 years. FTT parameters included maximum speed, time to onset of symptoms, distance ambulated, time ambulated, and back and leg pain severity before and after testing. Both groups had deterioration from the two-year to final FTT in maximum selected speed, time ambulated and time to onset of symptoms but the decline was greater in NonOp patients. Patients in the Op group had worse Post-FTT back and leg pain at baseline but improved more than the NonOp at two years and maintained at final FTT.Op patients with two or more revisions had less improvement at two years and at final FTT compared to those who had no revision or only one revision. Patients treated surgically had greater improvements in FTT parameters compared to patients treated nonsurgically at two years that persisted to the final FTT performed at 7 years after their intervention. There was slight deterioration in some parameters from the two year to final FTT but these may be due to aging of the cohort. Patients who had two or more revisions had worse FTT parameters compared to patients with one or no revisions.