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Younger Patients Are Differentially Affected by Stiffness-Related Disability Following Adult Spinal Deformity Surgery.
Abstract
OBJECT:The LSDI assesses the impact of lumbar stiffness on activities of daily living.
We hypothesized that patients <60 years-old would perceive greater lumbar stiffness-related
functional limitation following fusion for adult spinal deformity. METHODS:Patients
completed the LSDI and SRS-22r questionnaires preoperatively and at 2 years postoperatively.
The primary independent variable was patient age <60 vs. ≥60 years-old. Multivariable
regression analyses were utilized. RESULTS:In total, 267 patients were analyzed. Patients
<60 years-old (51.3%) and ≥60 years-old (48.7%) were evenly represented. In bivariable
analysis, patients <60 years-old exhibited lower LSDI at baseline vs. patients ≥60
years-old (25.7 vs. 35.5, β -9.8, p<0.0001), but a directionally smaller difference
at 2-years (26.4 vs. 32.3, β -5.8, p=0.0147). LSDI was associated with lower SRS-22r
total score among both patients <60 and ≥60 years-old, at both baseline and 2-years
(all p<0.0001); the association was stronger among patients <60 vs. ≥60 years-old
at 2 years. LSDI was associated with SRS satisfaction scores at 2 years among patients
<60 years-old (p<0.0001), but not patients ≥60 years-old (p=0.2250). The difference
in SRS satisfaction per unit LSDI between patients <60 years-old and >60 years-old
was significant (p=0.0021). CONCLUSIONS:Among ASD patients managed operatively, higher
LSDI was associated with inferior SRS-22r total score and satisfaction at 2 years
postoperatively. The association between increased LSDI and worse PROMs was greater
among patients <60 vs. ≥60 years old. Pre-operative counseling is needed for patients
<60 undergoing ASD surgery regarding the effects that lumbar stiffness may have on
post-operative function and satisfaction.
Type
Journal articlePermalink
https://hdl.handle.net/10161/19377Published Version (Please cite this version)
10.1016/j.wneu.2019.08.169Publication Info
Durand, Wesley M; Daniels, Alan H; Hamilton, David K; Passias, Peter G; Kim, Han Jo;
Protopsaltis, Themistocles; ... International Spine Study Group (2019). Younger Patients Are Differentially Affected by Stiffness-Related Disability Following
Adult Spinal Deformity Surgery. World neurosurgery. 10.1016/j.wneu.2019.08.169. Retrieved from https://hdl.handle.net/10161/19377.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Christopher Ignatius Shaffrey
Professor of Orthopaedic Surgery
I have more than 25 years of experience treating patients of all ages with spinal
disorders. I have had an interest in the management of spinal disorders since starting
my medical education. I performed residencies in both orthopaedic surgery and neurosurgery
to gain a comprehensive understanding of the entire range of spinal disorders. My
goal has been to find innovative ways to manage the range of spinal conditions, straightforward
to complex. I have a focus on managing patients with complex s

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