A new study published in Spine examines how neurologic deficits can impact patient-related outcomes for lumbar scoliosis surgical treatment in adults.
Researchers conducted a retrospective analysis of a National Institute of Health clinical trial to gather data for this study. The patients either had new postoperative neurological deficits after undergoing surgery for adult lumbar scoliosis, or no deficits. There were 141 patients included in the study and 9.9 percent had neurological deficits.
The researchers found:
1. Before surgery, there weren't any differences in the demographics, radiographic or patient-related outcomes data between the groups.
2. The patients who reported neurological deficit had longer procedures — 8.3 hours compared to 6.9 hours — and experienced more blood loss. The neurological deficit patients also stayed longer in the hospital — 10.6 days compared to 7.8 days.
3. Patients without neurological deficit reported significant improvement in all patient-related outcomes one year after surgery while the group with neurological deficits reported improvement in the SRS Pain and self-image domains; they also had improvements in the NRS back pain scores.
4. The patients with neurological deficits reported worsening NRS leg pain.
5. One year after surgery, the patients with neurological deficit reported worse ODI and PCS outcomes than the patients without neurological deficits.
"Most neurologic deficits improved by one-year follow-up, but appeared to have a dramatic negative impact on PROs, with increased postoperative leg pain and greater patient-perceived pathology reported in patients experiencing neurological deficits compared with those who did not," concluded the study authors.