98. Differences in functional treadmill tests in patients with adult symptomatic lumbar scoliosis treated operatively and nonoperatively

Abstract

BACKGROUND CONTEXT Adult symptomatic lumbar Scoliosis (ASLS) has become increasingly prevalent as the population ages. ASLS can be accompanied by neurogenic claudication, leading to difficulty walking. Functional treadmill testing (FTT) has been previously described as an objective tool to evaluate patients suffering from neurogenic claudication. FTT may provide an objective tool to evaluate patients with ASLS and identify patients who may benefit from surgical treatment. PURPOSE To determine if FTT demonstrates objective significant differences between patients treated surgically and nonsurgically for ASLS. STUDY DESIGN/SETTING Secondary analysis using data from the NIH sponsored study on ASLS that included randomized and observational arms. PATIENT SAMPLE Patients enrolled in the NIH sponsored study on ASLS. OUTCOME MEASURES Functional treadmill test, back and leg pain scores METHODS One hundred and eighty-seven patients who underwent nonsurgical (n=88) or surgical treatment (n=99) of ASLS with complete baseline and two-year post-treatment FTTs were identified. FTT parameters included maximum speed, time to onset of symptoms, distance ambulated, time ambulated, and the difference in back and leg pain before and after testing. RESULTS At baseline, patients treated operatively reported an onset of symptoms on FTT significantly sooner than those treated nonoperatively (5.5min vs 7.7min, p=0.025). When compared to baseline, operatively treated patients experienced significant improvement at 2 years in time ambulated (26.5min vs 24.4 min, p=0.001). Additionally, in the operative group, the post-treadmill minus pre-treadmill BP scores (0.5 vs 1.6 p=0.001) and the post-treadmill minus pre-treadmill leg pain scores (0.4 vs 1.4, p CONCLUSIONS FTT is a useful adjunct to assess treatment outcomes in patients with ASLS. FTT results were different at baseline between patients treated operatively and nonoperatively. Patients who had surgery had improvements in their post-treadmill minus pre-treadmill back and leg pain scores at two year follow-up. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.