Why Do Patients Seek a Spine Surgeon?

STUDY DESIGN: Retrospective review of chief complaints (CCs) of patients seeking care at a specialty spine clinic with the diagnosis of degenerative scoliosis or lumbar stenosis.

OBJECTIVES: The purpose of the study was to ascertain why patients seek care from spine surgeons. Specifically, we asked whether pain or deformity was more common. Secondarily, we studied the correlation of progressive curve magnitude with perceived functionality.

BACKGROUND: Scant research is available on what leads a patient to be seen in a clinic. Degenerative scoliosis is often correlated with pain in the low back and extremities, symptoms that impinge on quality of life in the elderly. Some research suggests there is no correlation between progressive curve magnitude and perceived functionality.

METHODS: Charts and radiographs of 351 consecutive patients were reviewed. Patient inclusion criteria were as follows: 1) they were seen at our spine clinic in one 12-month period, 2) their chief diagnosis was degenerative scoliosis or lumbar stenosis, 3) they were 50 years of age or older, and 4) they had no known prior history of scoliosis. Oswestry Disability Index (ODI) data were recorded.

RESULTS: Of 351 patients, 160 reported their CC was combination back + leg pain on the initial visit survey, 123 complained of back pain only, and 42 complained of leg pain only. Ten complained of deformity or deformity + pain. Patients with degenerative scoliosis + spinal stenosis represented 25% of the study population; 11% were diagnosed with degenerative scoliosis only; 64% with stenosis only. Of the 122 patients with a Cobb angle of greater than 10°, only 10 complained of deformity or deformity + pain on the initial visit survey.

CONCLUSIONS: Patients most often presented because of pain, specifically back, leg, or a combination of both. Patients seldom complained of deformity only, even among patients exhibiting a Cobb angle of greater than 30 degrees.