ArticleSpine deformity2020
Cost-effectiveness of adult lumbar scoliosis surgery: an as-treated analysis from the adult symptomatic scoliosis surgery trial with 5-year follow-up.
Article in Spine deformity, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Extent of fatty infiltration in lumbar paraspinal muscles in adults with degenerative scoliosis: segmental differences in muscle involvement.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Pooled it
- Methodology of economic evaluations in spine surgery: a systematic review and qualitative assessment.BMJ open · 2023Pooled it
- Prediction of lower limb compensation for adult degenerative spine patients using spinopelvic parameters: a machine learning approach.BMC musculoskeletal disorders · 2026Article
- Surgical invasiveness, reoperation, and preoperative depression are predictive of super-utilization in adult spinal deformity surgery.Spine deformity · 2026Article
- Comparison of quality of life between operated and non-operated adults with painful degenerative scoliosis: a 2-year prospective multicentered observational study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Observational
- A retrospective analysis of patients deemed ineligible for surgery in a multidisciplinary complex spine conference.Spine deformity · 2025Article
- Iatrogenic posterior translation of the construct at the uppermost instrumented vertebrae is associated with proximal junctional kyphosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Time trends in spine surgery in Italy: a nationwide, population-based study of 1,560,969 records of administrative health data from 2001 to 2019.Acta orthopaedica · 2025Article
- Psychological distress does not predict decisional regret in patients undergoing spinal reconstruction for adult spinal deformity.BMC musculoskeletal disorders · 2024Article
- Readmission rate after adult scoliosis surgery on primary cases over 45 years-old with long term follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Radiographic Alignment in Deformity Patients Treated With Personalized Interbody Devices: Early Experience From the COMPASS Registry.International journal of spine surgery · 2024Article
- Importance of modifiable non-radiographic functional parameters for adult spinal deformity.Scientific reports · 2024Article
- How coronal malalignment affects the surgical outcome in corrective spine surgery for adult symptomatic lumbar deformity.Spine deformity · 2024Article
- Osteobiologics and Value-Based Care: Challenges and Opportunities.International journal of spine surgery · 2023Article
- Clinical and Economic Impact of Proximal Junctional Kyphosis on Pediatric and Adult Spinal Deformity Patients.International journal of spine surgery · 2023Article
- Proximal Junctional Kyphosis Prevention Strategies Focused on Alignment.International journal of spine surgery · 2023Article
- No Significant Radiological Signs of Adult Spinal Deformity Progression after a Mean of 11 Years of Follow-Up Following Harrington Rod Instrumentation Removal and Watchful Waiting.Healthcare (Basel, Switzerland) · 2023Article
- Adult Spinal Deformity: A Comprehensive Review of Current Advances and Future Directions.Asian spine journal · 2022Article
- [Cost coverage for complex paediatric spinal deformities with preoperative halo traction-an economic problem?]Der Orthopade · 2021Article
- The Scoliosis Research Society adult spinal deformity standard outcome set.Spine deformity · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
STUDY
designLongitudinal comparative cohort.
objectiveThe purpose of this study is to report on the cost-effectiveness of surgical versus non-surgical treatment for Adult Symptomatic Lumbar Scoliosis (ASLS) using the as-treated data and provide a comparison to previously reported intent-to-treat (ITT) analysis. Adult spinal deformity is a relatively prevalent condition for which surgical treatment has become increasingly common but concerns surrounding complications, revision rates and cost-effectiveness remain unresolved. Of these issues, cost-effectiveness is perhaps the most difficult to quantify as the requisite data is difficult to obtain. The purpose of this study is to report on the cost-effectiveness of surgical versus non-surgical treatment for ASLS using the as-treated data and provide a comparison to previously reported ITT analysis.
methodsPatients with at least 5-year follow-up data within the same treatment arm were included. Data collected every 3 months included use of nonoperative modalities, medications and employment status. Costs for surgeries and non-operative modalities were determined using Medicare Allowable rates. Medication costs were determined using the RedBook and indirect costs were calculated based on the reported employment status and income. Quality-Adjusted Life Years (QALY) was determined using the SF-6D.
resultsOf 226 patients, 195 patients (73 Non-op, 122 Op) met inclusion criteria. At 5 years, 29 (24%) patients in the Op group had a revision surgery of whom two had two revisions and one had three revisions. The cumulative cost for the Op group was $111,451 with a cumulative QALY gain of 2.3. The cumulative cost for the Non-Op group was $29,124 with a cumulative QALY gain of 0.4. This results in an ICER of $44,033 in favor of Op treatment.
conclusionThis as-treated cost-effectiveness analysis demonstrates that surgical treatment for adult lumbar scoliosis becomes favorable at year-three, 1 year earlier than suggested by a previous intent-to-treat analysis. LEVEL OF EVIDENCE: II.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.