Spine Patients Choose Surgery to Improve Functioning

Patients with serious spinal deformities are less interested in pain relief, more interested in walking
By Jeff Muise
HealthDay Reporter

FRIDAY, April 17 (HealthDay News) -- Improving daily functioning, such as walking, rather than relieving pain is the primary reason that people with back deformities choose risky surgery over nonoperative therapies, according to a report in the April 15 issue of Spine.

Murat Pekmezci, M.D., of the University of California in San Francisco, and colleagues investigated the basis for deciding between operative and nonoperative treatment in a cohort of adults (greater than 18 years of age) with back deformities. They reviewed medical records of patients who came to a spinal clinic from 2003 to 2006, including SF-12, SRS-30, and Oswestry Disability Index questionnaires, radiographs, reports of pain episodes, and demographic data. Differences between patients who chose surgery and those who did not were assessed.

The researchers found that functional domain scores were worse among the patients who chose surgery than those who chose nonoperative treatment. In particular, the operative group scored low in walking as measured by the Oswestry Disability Index, and low in vitality as measured by the SRS-30 questionnaire. Pain scores in assessment questionnaires were similar for both the operative and nonoperative groups.

"In summary, this study demonstrated that despite the general belief, the factors such as magnitude of deformity, comorbidities, body mass index, and pain levels are not as important as previously thought when a patient decides to have operative or nonoperative treatment. The functional compromise is more important for adult deformity patients as a motivation to proceed with operative treatment," the authors write.

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