Differences in Functional Treadmill Tests in Patients With Adult Symptomatic Lumbar Scoliosis Treated Operatively and...

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 nonoperatively (NonOp).

A previous study on this cohort showed that at 2 years after intervention, FTT time ambulated deteriorated in NonOp patients but improved in Op patients. Post-FTT back and leg pain improved in both groups with greater gains in the Op group.

One hundred sixty-eight (62%) of 272 surviving subjects who underwent operative (Op, N = 115) or nonoperative 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 2-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 2 years and maintained at final FTT.Op patients with 2 or more revisions had less improvement at 2 years and at final FTT compared with those who had no revision or only 1 revision.

Patients treated surgically had greater improvements in FTT parameters compared with patients treated nonsurgically at 2 years that persisted to the final FTT performed at 7 years after their intervention. There was slight deterioration in some parameters from the 2-year to final FTT but these may be due to aging of the cohort. Patients who had 2 or more revisions had worse FTT parameters compared with patients with 1 or no revisions.