The Journal of Bone and Joint Surgery, Vol 77, Issue 4 513-523, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Results of operative treatment of idiopathic scoliosis in adults
JH Dickson, S Mirkovic, PC Noble, T Nalty and WD Erwin
Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
We compared the results in eighty-one patients (average age, fifty-six
years; range, forty-three to eighty-three years) who had had operative
treatment of idiopathic scoliosis with those in thirty patients (average
age, fifty-eight years; range, forty-five to seventy years) who had
declined operative treatment. Seventy-six individuals (average age,
forty-eight years; range, thirty-five to seventy-four years) who did not
have scoliosis served as a control group. The average duration of follow-up
was five years (range, two to seventeen years). The population base
consisted of 454 patients who were seen between 1970 and 1985. The treated
patients were drawn from a group of 160 patients for whom an operation had
been recommended; 110 patients agreed to the operation and fifty refused.
The remaining 294 patients had curves of insufficient severity to warrant
concern about progression, had symptoms unrelated to the scoliosis, or had
curves that did not necessitate any intervention. The functional status
since the operation (for the treated patients), since recommendation of the
operation (for the untreated patients), or within the last ten years (for
the control group) was evaluated with a comprehensive questionnaire
designed to elicit details regarding pain, fatigue, and any disability in
the performance of twenty-six activities of daily living. At the most
recent follow-up examination, the treated patients reported a significantly
greater decrease in pain and fatigue and significantly more improvement in
self-image and in the ability to perform physical, functional, and
positional tasks than did the untreated patients (p = 0.0001).
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