MedPath

Cost Effectiveness of Nonoperative Management for Adult Spinal Deformity

Completed
Conditions
Spinal Deformity
Registration Number
NCT01880164
Lead Sponsor
Shay Bess
Brief Summary

Quantify the efficacy and cost of nonoperative treatment modalities used for adult spinal deformity.

Detailed Description

1. Identify disease burden associated with adult spinal deformity (ASD) using quality adjusted life year (QALY) analysis.

2. Identify disease burden of specific demographic and radiographic features associated with ASD.

3. Compare disease burden of ASD to other musculoskeletal and non-musculoskeletal diseases.

4. Identify efficacy of specific nonoperative treatment modalities to treat ASD and identify specific clinical and radiographic features of ASD responsive to nonoperative treatment modalities.

5. Compare QALY and ICER values for different ASD nonoperative treatment modalities to previously established QALY and ICER for values for operative and nonoperative treatment modalities for degenerative hip and knee disease, coronary artery disease, insulin dependent diabetes, and hypertension.

6. Evaluate the cost and work hours associated with data collection and minimum 85% patient follow up.

7. Evaluate patient characteristics associated with poor patient compliance for study follow up including demographic, radiographic and HRQOL values and for reasons for cross-over to operative treatment for ASD.

8. Establish standardized data collection methodology for economic based outcome studies based upon patient demographics and HRQOL values.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
21
Inclusion Criteria
  1. Age 40-75 years of age at the time of enrollment.
  2. ODI ≥30
  3. Adult degenerative or idiopathic lumbar scoliosis 10-40° as measured by the Cobb angle technique
  4. Sagittal plane deformity by SRS Schwab classification with at least one modifier ++ or two modifiers + and associated coronal cobb of at least 10 degrees
Exclusion Criteria
  1. Adult degenerative or idiopathic scoliosis with a curvature of the spine measuring <10 degrees or >40 degrees
  2. Diagnosis of scoliosis other than degenerative or idiopathic (i.e. neuromuscular, congenital, etc.)
  3. Cardiopulmonary disease or comorbidities that preclude surgical intervention
  4. Patient not deemed surgical candidate by treating surgeon
  5. Patient unwilling to commit to monthly phone interviews or completion of necessary questionnaires or inability to return for defined follow up time points. Patients unwilling to comply with study protocol will not be offered enrollment into the study, regardless of meeting inclusion criteria.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Oswestry Disability Index (ODI)Initial visit and six months post enrollment

This questionnaire has been designed to provide information as to how back pain affects ability to manage in everyday life. Score must be equal to or greater than 30 for eligibility to enroll.

Secondary Outcome Measures
NameTimeMethod
RadiographsInitial visit (Day 1)

Coronal and sagittal radiographic views of the spine obtained to assess coronal curvature and sagittal balance.

Trial Locations

Locations (10)

University of California - Davis

🇺🇸

Sacramento, California, United States

University of California - San Francisco Medical Center

🇺🇸

San Francisco, California, United States

Rocky Mountain Scoliosis and Spine

🇺🇸

Denver, Colorado, United States

Norton Leatherman Spine Center

🇺🇸

Louisville, Kentucky, United States

Washington University at St. Louis

🇺🇸

St. Louis, Missouri, United States

NYU Hospital for Joint Diseases

🇺🇸

New York, New York, United States

Hospital for Special Surgery

🇺🇸

New York, New York, United States

Oregon Health Sciences University

🇺🇸

Portland, Oregon, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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