• Sung Hoon Choi, Seung Min Son, Tae Sik Goh, Wonseok Park, and Jung Sub Lee.
• Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
• World Neurosurg. 2018 Sep 3.

BackgroundMore recent studies have focused on clinical outcomes of operative versus nonoperative treatment in patients with adult spinal deformity (ASD). However, scientific support for ASD surgery is weak. We compared outcomes of operative and nonoperative treatment of ASD with minimum 2-year follow-up in a meta-analysis.MethodMEDLINE and EMBASE databases, from the earliest available date of indexing through May 10, 2018, were searched for studies evaluating outcomes of operative and nonoperative treatment of ASD. Two authors performed data extraction independently. Any discrepancies were resolved by consensus.ResultsFour comparative studies were identified. Postoperative back pain numeric rating scale and leg pain numeric rating scale scores were significantly lower with operative treatment compared with nonoperative treatment (P < 0.00001, weighted mean difference [WMD] = -2.76 [-3.45, -2.07] vs. P < 0.0001, WMD = -2.31 [-3.33, -1.28]). Postoperative Oswestry Disability Index and Scoliosis Research Society-22 questionnaire scores were significantly better with operative treatment compared with nonoperative treatment (P < 0.00001, WMD = -10.96 [-13.56, -8.36] vs. P < 0.00001, WMD = 0.68 [0.48, 0.87]). The complication rate of operative treatment was 17%-71.5%.ConclusionsOur meta-analysis showed that operative treatment has been demonstrated to significantly reduce disability and pain and to improve clinical outcomes compared with nonoperative treatment. Further large, multicenter, well-designed studies are necessary to substantiate our results.Copyright © 2018. Published by Elsevier Inc.

4 keywords...

hide…