The management of adult spinal deformity is characterized by significant variability. It includes patients with a broad spectrum of symptoms, comorbidities, and treatment goals. Indications for surgery, preoperative preparations, intraoperative strategies, and postoperative care are variable between providers, and within the community of physicians who care for patients with spinal disorders. The presence of variability is clear evidence of the absence and need of an evidence-based approach for the management of adult spinal deformity.  Therefore, the AOSpine Knowledge Forum Deformity has embarked upon a project which is being led by Principal Investigator, Dr. Sigurd Berven, Orthopaedic Spine Surgeon from the University of California San Francisco, and Co-principal Investigator, Prof.  Marinus de Kleuver, Professor of Spine Surgery and VU Medisch Centrum and Spine Surgeon at Sint Maartenskliniek in the Netherlands to determine the appropriate approaches and management strategies for the treatment of adults with spinal deformity.

 

The project was conceived in October 2014, and by using a modified Delphi process (a well-defined methodology designed to establish consensus through an iterative and anonymous process), they hope to use the expert opinions of deformity spine surgeons worldwide and supporting literature to explore this issue. Expert recommendations from a sample of experienced surgeons encompassing geographically diverse regions with distinct training and specialties will incorporate a range of recommendations that will define reasonable and appropriate care, without mandating a monolithic approach.

By December 2014, AOSpine surgeons were recruited and selected through an open call. Fifty-three experienced spine deformity surgeons (panelists) representing 24 diverse countries, participated in the study. Over a 7-month period, they provided their opinion in three rounds of questionnaires. The questionnaires were completed and returned online.

To complete the final round of the Delphi process, an engaging and successful meeting took place during the 22nd International Meeting on Advanced Spine Techniques (IMAST) in Kuala Lumpur, Malaysia. Twenty-one of the 53 panelists attended and represented their regions in the face-to-face discussions. Items which were considered ambiguous and required further clarification were discussed and re-voted on by the panelists.

 

Currently, Dr. Berven and Prof. de Kleuver are working together with their research team to consolidate the results which they hope to publish in the near future.

 

They are grateful to the 53 expert surgeon panelists for their contributions.

 

Please stay tuned for the upcoming publications regarding appropriate treatment for adults with spinal deformity.

 

For further information about Knowledge Forum activities, please visit our website here.