Jeffrey L. Gum
CHICAGO — Patients with adult symptomatic lumbar scoliosis experienced a high non-thoracolumbar orthopedic disease burden requiring surgery within 4 years, according to results presented at the North American Spine Society Annual Meeting.
Jeffrey L. Gum, MD, and colleagues assessed the incidence of non-thoracolumbar orthopedic disease burden among randomized and observational cohorts of 286 patients with adult symptomatic lumbar scoliosis treated either operatively or nonoperatively.
“We defined NTO, or non-thoracolumbar orthopedic disease burden, as orthopedic conditions requiring surgical treatment in fractures not involving the thoracolumbar spine,” Gum said in his presentation here.
Gum noted 63 patients and 223 patients were included in the randomized and observational cohorts, respectively, with 90% follow-up at 4 years.
“Among the 286 symptomatic scoliosis patients, 104 NTO events occurred within the 4 years of enrollment,” Gum said.
Within 4 years of study enrollment, 10% of patients underwent at least one arthroplasty, with knee arthroplasty being the most common, followed by shoulder arthroplasty, hip arthroplasty and great toe arthroplasty, according to Gum. He added 8% of patients experienced fracture events, with foot and ankle fracture being the most common, followed by patella fracture and shoulder fracture, and 4% of patients underwent joint ligament or cartilage repair.
“In the multivariate model, the factors independently associated with [non-thoracolumbar orthopedic disease burden] events were greater age, current or former smoker or nicotine use, greater [pelvic incidence-lumbar lordosis] PI-LL mismatch and greater baseline leg pain,” he said. – by Casey Tingle
Smith JS, et al. Abstract 19. Presented at: North American Spine Society Annual Meeting; Sept. 25-28, 2019; Chicago.
Disclosure: Gum reports he receives royalties from Acuity; has private investments in Cingulate; is a consultant for Medtronic, Acuity, K2M, NuVasive and Mazor; has speaking or teaching arrangements with Medtronic; receives payment for travel from Broadwater; is on the scientific advisory board for Medtronic and K2M; and receives research support as staff or for materials from Pfizer, Intellirod and Texas Scottish Rite Hospital/Scoliosis Research Society.