The factors that play a role in the decision-making process of adult deformity patients.
METHODS
Retrospective matched cohort.


OBJECTIVE
To investigate the factors that may affect the decision-making process of adult deformity patients.


BACKGROUND
Adult deformity is a significant cause of morbidity in the elderly population. Despite high complication rates a significant number of patients still prefer operative treatment. Analysis of the factors that drive these patients to operative treatment would help surgeons to better evaluate these patients.


METHODS
Adult deformity patients who are evaluated in a single institute were reviewed. The inclusion criteria were being >18 years old, having a coronal curve magnitude of >30 degrees , having no previous surgery or associated neuromuscular or inflammatory condition, having completed SF-12, SRS-30, and Oswestry Disability Index questionnaires in the initial visit, and having a complete set of radiographs. The demographic data as well as back and leg pain incidences and magnitudes were collected. The eligible patients were compared first as age-gender-curve type matched cohorts.


RESULTS
Functional domain scores particularly walking in Oswestry Disability Index and vitality in the SRS-30 were significantly worse in the operative treatment group, whereas the pain scores were similar in both groups in all outcomes assessment questionnaires. Besides, there was no difference among 2 groups with respect to either the incidence or the magnitude of back or leg pain.


CONCLUSIONS
These results suggest that functional limitations are more important than pain for adult deformity patients when deciding for operative or nonoperative treatment.
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
Murat
M
Pekmezci
Sigurd H
SH
Berven
Serena S
SS
Hu
Vedat
V
Deviren
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care / Q000379:methods / Q000523:psychology; D012189:Retrospective Studies; D012600:Scoliosis / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult