title: Surgical versus nonsurgical treatment of lumbar degenerative kyphosis.
abstract: Surgery is widely performed for lumbar degenerative kyphosis (LDK), but its effectiveness as compared with nonsurgical treatment has not been demonstrated.
  
  
  
  In this prospective study, surgical candidates with LDK were enrolled at three spine centres. Two treatment options were performed either surgery using a pedicle subtraction osteotomy or nonsurgical care. Outcomes were measured using a Visual analogue scale (VAS) of back pain as a primary endpoint, the Oswestry disability index (ODI), the 36-item short-form health survey (SF-36), sagittal vertical axis (SVA) and treatment-related complications.
  
  
  
  Of the 126 LDK patients treated during the reference period, 97 patients were enrolled (47 in the surgical group and 50 in the nonsurgical group). Surgical group produced statistically reduced VAS of back pain and better functional outcomes than nonsurgical group since 12 months after treatment, but the rate of serious complications was higher after surgery. Interestingly, both surgical and nonsurgical groups had improved outcomes in terms of pain intensity and function at the 2-year follow-up period.
  
  
  
  Surgery might be a preferred treatment option for LDK, but great caution is needed. And conservative treatment could be the considerable treatment option for LDK who is unwilling or has poor medical condition to operate.
authors.affiliation: Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea.
authors.forename: Tae Sik
authors.initials: TS
authors.lastname: Goh
authors.affiliation: Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea.
authors.forename: Jong Ki
authors.initials: JK
authors.lastname: Shin
authors.affiliation: Department of Orthopaedic Surgery, Myungeun Hospital, Busan, Republic of Korea.
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Youn
authors.affiliation: Lee Hong Seok Orthopaedic Hospital, Busan, Republic of Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea.
authors.forename: Taek Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea. jungsublee@pusan.ac.kr.
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000072700:Conservative Treatment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Conservative; Lumbar degenerative kyphosis; Nonsurgical; Pedicle subtraction osteotomy; Surgery