Surgery is an Effective and Reasonable Treatment for Degenerative Scoliosis: A Systematic Review

Abstract

OBJECTIVE: A systematic review to evaluate the role of surgery for treating degenerative scoliosis (DS) in terms of improved function (Oswestry Disability Index [ODI]) and correction of deformity (Cobb angle); safety outcomes included complication and repeat surgery rates. METHODS: A search of the MEDLINE, ISI Web of Knowledge and Cochrane Library databases was performed. The methodological quality of each study was assessed according to standardized criteria and data were extracted. RESULTS: A total of 16 studies including 553 patients with DS met the eligibility criteria for inclusion. The mean ODI score at final follow-up was 36.0 ± 7.8 (304 patients) and the mean decrease in ODI was 23.3 ± 11.3 (302 patients). Mean reduction in curve angle (as a percentage of the original curve) was 48.5 ± 21.0% (527 patients). The overall incidence of complications was 49.0% (171 in 349 patients) and the rate of repeat surgery was 15.3% (61 in 398 patients). CONCLUSIONS: Despite a high incidence of complications and reoperations, surgery was an effective and reasonable treatment for DS, providing significant functional improvement and deformity correction.