Cost and value of spinal deformity surgery

Area of Science:

• Orthopedics and Spine Surgery
• Health Economics
• Quality of Life Research

Background:

• Growing interest in quality of life (QoL) for adult scoliosis patients.
• Comparison of nonoperative versus surgical management outcomes.
• Review of current literature to guide treatment decisions.

Purpose of the Study:

• Assess QoL in adult scoliosis patients undergoing nonoperative and/or surgical treatment.
• Evaluate the cost-effectiveness of various scoliosis treatment modalities.

Main Methods:

• Literature review of MEDLINE and PubMed databases.
• Inclusion of studies on adult scoliosis with primary surgery or nonoperative management.
• Exclusion of adolescent scoliosis and studies solely on postoperative outcomes.

Main Results:

• Validated QoL measures include SRS-22, Oswestry Disability Index, SF-12, and pain scales.
• Thirteen studies analyzed QoL changes from baseline in adult scoliosis treatments.
• A trend towards improved QoL was observed in patients receiving surgical treatment.

Conclusions:

• Surgical intervention may benefit adult scoliosis patients with painful, disabling conditions.
• Nonoperative treatment appears less cost-effective and does not significantly improve QoL.
• Further prospective studies are needed to confirm surgical superiority in QoL and cost-effectiveness.