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Determining the Best Treatment for Scoliosis

A study at Washington University School of Medicine will help determine the most effective treatments for adults with scoliosis. “We don’t always know the best way to treat adults with scoliosis because no prospective outcomes studies exist to verify what best corrects the spinal deformity and improves quality of life in adults,” says Keith Bridwell, MD, the Asa C. and Dorothy W. Jones Distinguished Professor of Orthopaedic Surgery, adjunct professor of neurological surgery and chief of orthopaedic spine surgery.

Treatment options include observation, physical therapy, medications and surgery. The Spinal Deformity Study Group/Adult Deformity Outcomes study involves Bridwell and investigators at five centers around North America. They are studying adult scoliosis patients treated either operatively or non-operatively, and comparing patient outcomes over time.

The investigators follow patients for two years to assess quality of life, back pain and leg pain. Two years after surgery, they assess walking speed and tolerance compared to what patients were like prior to surgery. Those treated nonoperatively will go through the same battery of evaluations. “We have ideas about who does best with which treatments,” Bridwell says. “But there isn’t prospective, comparative data to validate our judgments about what happens in the long run. Factors such as the location of the curve in the spine, the degree and extent of curvature and its potential to get worse have guided past decisions. But we want to include outcomes in that equation.”

This study is sponsored by the National Institutes of Health (NIH). Investigators will enroll 300 patients (150 surgical and 150 nonoperative), and those patients will receive compensation for their involvement. The $2.5 million project runs five years. It is the most extensive study ever funded for adult spinal deformity and is the only NIH-sponsored study of adult spinal deformity.
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