TY - JOUR
T1 - Team Approach
T2 - Degenerative Spinal Deformity
AU - Berven, Sigurd
AU - Jain, Deeptee
AU - O'Neill, Conor
AU - Selinger, Amy
AU - Mummaneni, Praveen
N1 - Publisher Copyright:
© 2017 BY The Journal Of Bone and Joint Surgery, Incorporated.
PY - 2017
Y1 - 2017
N2 - Degenerative spinal deformity is common and affects a large percentage of the aging population. The burden of degenerative spinal deformity is high when measured on the basis of prevalence, impact, and cost of care. A broad spectrum of specialists treat degenerative spinal deformities with use of both nonoperative and operative approaches to care. Treatment is characterized by substantial variability between and within specialties. Optimal care maximizes clinical benefit while limiting risks and costs. This review describes the case of a 68-year-old woman with symptomatic degenerative scoliosis and presents perspectives on management from specialists in physical therapy, pain management, neurosurgery, and orthopaedic surgery. The approaches to care presented here encompass a spectrum of risks, costs, and expected outcomes. Each specialist presents a perspective that is appropriate and reasonable, with its expected risks and benefits. The best approach is one that is not monolithic; collaboration between providers from multiple disciplines permits an approach to care that is responsive to the values and preferences of the individual patient. Clinical research, including prospective multidisciplinary comparative studies, is important for guiding an evidence-based approach to specific clinical scenarios and for developing a consensus regarding appropriate management strategies.
AB - Degenerative spinal deformity is common and affects a large percentage of the aging population. The burden of degenerative spinal deformity is high when measured on the basis of prevalence, impact, and cost of care. A broad spectrum of specialists treat degenerative spinal deformities with use of both nonoperative and operative approaches to care. Treatment is characterized by substantial variability between and within specialties. Optimal care maximizes clinical benefit while limiting risks and costs. This review describes the case of a 68-year-old woman with symptomatic degenerative scoliosis and presents perspectives on management from specialists in physical therapy, pain management, neurosurgery, and orthopaedic surgery. The approaches to care presented here encompass a spectrum of risks, costs, and expected outcomes. Each specialist presents a perspective that is appropriate and reasonable, with its expected risks and benefits. The best approach is one that is not monolithic; collaboration between providers from multiple disciplines permits an approach to care that is responsive to the values and preferences of the individual patient. Clinical research, including prospective multidisciplinary comparative studies, is important for guiding an evidence-based approach to specific clinical scenarios and for developing a consensus regarding appropriate management strategies.
UR - http://www.scopus.com/inward/record.url?scp=85017664830&partnerID=8YFLogxK
U2 - 10.2106/JBJS.RVW.16.00058
DO - 10.2106/JBJS.RVW.16.00058
M3 - Review article
C2 - 28375863
AN - SCOPUS:85017664830
SN - 2329-9185
VL - 5
JO - JBJS reviews
JF - JBJS reviews
IS - 4
M1 - 00058
ER -