Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series.
OBJECTIVE
The surgical approach to adult spine deformities is complex and presents a high incidence of complications.


METHODS
We report here a prospective consecutive case series analysis of 20 patients submitted to posterior correction and instrumented fusion for adult degenerative scoliosis. Clinical outcomes were assessed by self-reported measures. Pre-operative and post-operative complications were analysed during a mean 30-month follow-up period.


RESULTS
Eleven patients (55 %) presented pre-operative or post-operative complications. Fifteen different complications occurred, six in the early pre-operative period and nine during follow-up period: ten of these complications occurred in patients who underwent a previous surgery for spine disease.


CONCLUSIONS
The clinical improvement at the final follow-up resulted as statistically significant only for the group of patients exposed to posterior fusion without interbody fusion. The observations reported here have to be considered for a shared decision-making in the management of adult scoliosis.
Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopaedic Institute, via G.C. Pupilli 1, 40136, Bologna, Italy, giovanni@barbantibrodano.com.
Giovanni
G
Barbanti Bròdano
Silvia
S
Terzi
Alessandro
A
Gasbarrini
Stefano
S
Bandiera
Christiano
C
Simoes
Stefano
S
Boriani
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D018570:Risk Assessment; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome