Nonsurgical resource utilization in adult spinal deformity

Abstract

Study design: The enrollment data were retrospectively reviewed for 1,061 patients entered into a prospective multicenter study of adult spinal deformity between January 2002 and June 2004.

Objective: The purpose of this study is to quantify and analyze the use of nonsurgical resources in patients with adult spinal deformity.

Summary of background data: Limited data exist regarding the utilization of nonsurgical treatment methods for adult spinal deformity.

Methods: Demographic data, surgical history, symptom assessment, and nonsurgical treatment regimen were reviewed. Health status measures were the SF-12, SRS-29, and ODI. Nonsurgical patients were divided into low- and high-symptom subgroups based on age adjusted ODI score. Resource utilization was analyzed based on both patient and physician questionnaire responses.

Results: High- and low-symptom nonsurgical subgroups differed significantly on all reported health status measures (P < 0.0001). High-symptom patients used greater resources in terms of narcotics, epidural blocks, and physical agent methods (P < 0.001), analgesics (P < 0.01), pain management referral and bed rest (P < 0.02), strength training, nerve root blocks, and stabilization exercises (P < 0.05).

Conclusions: The results of this study demonstrate that, within the population of adult deformity patients, distinct high- and low-symptom groups exist and can be clearly identified. While high-symptom patients used significantly greater resources, most low-symptom patients used nonsurgical resources as well.