Outcomes, Expectations, and Complications Overview for the Surgical Treatment of Adult and Pediatric Spinal Deformity

The aim of this article was to summarize current literature on surgical treatment of pediatric and adult spinal deformity with regard to clinical outcomes and surgical complications. When surgery is considered for treatment of spinal deformity, it is important for both the physician and patient to appreciate the outcome objectives, have reasonable expectations, and understand the potential for adverse events. We conducted a comprehensive search of the English literature from the years 2000–2011 using Medline for articles related to the surgical treatment of spinal deformity, using selected terms. We reviewed abstracts and restricted them to those focused on surgical treatment of spinal deformity. We included clinical outcomes measures and overall complications rates, and reviewed corresponding manuscripts. For pediatric and adult spinal deformity, we identified 8 and 17 manuscripts, respectively, that included preoperative and postoperative assessments of outcomes measures. The vast majority of reported studies demonstrated that operative treatment has the potential to produce significant improvement of health-related quality of life. Surgical treatment of pediatric scoliosis, including idiopathic, neuromuscular, and congenital, had reported complication rates ranging from 4.4% to 15.4%, 17.9% to 48.1%, and 8.3% to 31%, respectively. Surgical treatment of adult scoliosis had reported overall complication rates ranging from 10.5% to 96%. The number of high-quality studies that provide assessment of the outcomes of surgery for pediatric and adult scoliosis remains limited; further study is needed. Available studies suggest that in selected patients, surgical treatment offers potential for improvement of health-related quality of life. The current literature also demonstrates the risks that accompany surgical procedures for the correction of spinal deformity. It is important that spinal deformity patients considering surgical treatment have appropriate expectations not only of the potential benefits it may offer, but also of the risks inherent to such procedures.