Non-surgical treatment for adult spinal deformity: results of an intensive combined physical and psychological programme for patients with adult spinal deformity and chronic low back pain—a treatment-based cohort study

• Published in: European spine journal 2022-05, Vol.31 (5), p.1189-1196
• Main Authors: Hoevenaars, Evelien H. W., Beekhuizen, Michiel, O’Dowd, John, Spruit, Maarten, van Hooff, Miranda L.
• Format: Article
• Language: English
• Subjects: Back pain; Cohort analysis; Cross-sectional studies; Low back pain; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Patients; Quality of life; Surgical Orthopedics
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-022-07156-4

Objectives No evidence-based treatment exists for adult spinal deformity (ASD) patients with chronic low back pain (CLBP). Aim of this study: evaluate a combined physical and psychological programme (CPPP) for ASD patients with CLBP and to compare this with a non-ASD-cohort with CLBP. Methods Data were extracted from the database of CLBP-patients for whom surgery is not an option and completed CPPP. Two cohorts were selected: an ASD-cohort ( n  = 80) based on a Cobb angle of > 10° and a consecutive age- and gender-matched non-ASD-cohort ( n  = 240). Primary outcome: functional status (Oswestry Disability Index; ODI). Secondary outcomes: pain intensity, self-efficacy and quality of life. Assessments: pre and post treatment, one-month and one-year follow-up (FU). Clinical relevance: minimal important clinical change (MCIC; ODI 10 points), patient acceptable symptom state (PASS; ODI ≤ 22). Results Demographics ASD-cohort: 79% female, mean age 50.9 (± 14.1) years, mean CLBP duration 15.5 (± 12.5) years, mean Cobb angle 21.4 (± 9.4)°. Non-ASD-cohort: not significantly different. Both cohorts improved in functional status (F[1,318] = 142.982, p