Resource Utilization

Spinal Curvature: Adult Scoliosis
 
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III.D.2.2
Spinal Curvature: Adult Scoliosis

Lead Author(s): 

Adolfo Correa, MD, PhD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

The management of adult scoliosis includes nonsurgical and surgical resources. Nonsurgical treatments of adult scoliosis utilize significant resources, and include interventions such as exercises, physical therapy, injections, pain medications, and manual manipulation.1 Data on nonsurgical treatments is not available; however, a 2010 non-randomized study reported that two years of nonsurgical treatment in adult scoliosis patients resulted in substantial expenditures and yielded no improvement in health status.2

Operative management of scoliosis in the adult encompasses a spectrum of procedures including decompression alone, decompression with limited fusion, and fusion of the deformity. In 2011, a query of the Healthcare Costs and Utilization Project (HCUP) Nationwide Inpatient Survey (NIS) resulted in approximately 229,100 hospitalizations associated with a discharge diagnosis of scoliosis or spinal curvature (ICD-9-CM of 373). The majority of these, or 155,900 patients, were diagnosed as idiopathic scoliosis, or scoliosis of unknown cause. Most of the remaining discharges, 66,000 people, were associated with a primary diagnosis of acquired adult scoliosis, while the remaining 10,500 discharges were associated with adult scoliosis as the secondary diagnosis to another condition. (Reference Table 3.1.1 PDF CSV)

In 2011, nearly 27.6 thousand patients admitted to the hospital with a diagnosis of scoliosis underwent a decompression procedure. Among patients having decompression, 82% also had spinal fusion, with 42% undergoing fusion of one to three levels, while 34% had fusion of four or more levels. Overall, 22% of all scoliosis patients underwent a fusion procedure (N=50,009), with 10% having fusion of one to three levels and 12% fusion of four or more levels.
Scoliosis Diagnoses Discharges with Decompression Procedures with and without Fusion, United States, 2011
In 2011, only about one-half (53%) of patients with a scoliosis diagnosis were discharged to home, while 70% of patients discharged for any diagnosis had a routine discharge. Patients with a scoliosis diagnosis are more likely to be transferred to a skilled nursing or intermediate care facility than are patients with all diagnoses. This is particularly true for the elderly population, with 46% of persons age 75 and older with a scoliosis diagnosis moving to a long-term care facility. (Reference Table 3.3.1 PDF CSV)
Hospital Discharge Status for Scoliosis Diagnoses Patients by Age, United States 2011

  • 1. Glassman SD, Berven S, Kostuik J, Dimar JR, Horton WC, Bridwell K: Nonsurgical resource utilization in adult spinal deformity. Spine 2005;30(4):418-426.
  • 2. Glassman SD, Carreon LY, Shaffrey CI, Polly DW, Ondra SL, et. al: The costs and benefits of nonoperative management for adult scoliosis. Spine 2010:35:578-82.

Edition: 

  • 2014

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