Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery?

dc.contributor.author

Park, Paul

dc.contributor.author

Okonkwo, David O

dc.contributor.author

Nguyen, Stacie

dc.contributor.author

Mundis, Gregory M

dc.contributor.author

Than, Khoi D

dc.contributor.author

Deviren, Vedat

dc.contributor.author

La Marca, Frank

dc.contributor.author

Fu, Kai-Ming

dc.contributor.author

Wang, Michael Y

dc.contributor.author

Uribe, Juan S

dc.contributor.author

Anand, Neel

dc.contributor.author

Fessler, Richard

dc.contributor.author

Nunley, Pierce D

dc.contributor.author

Chou, Dean

dc.contributor.author

Kanter, Adam S

dc.contributor.author

Shaffrey, Christopher I

dc.contributor.author

Akbarnia, Behrooz A

dc.contributor.author

Passias, Peter G

dc.contributor.author

Eastlack, Robert K

dc.contributor.author

Mummaneni, Praveen V

dc.contributor.author

International Spine Study Group

dc.date.accessioned

2023-07-20T15:26:07Z

dc.date.available

2023-07-20T15:26:07Z

dc.date.issued

2016-02

dc.date.updated

2023-07-20T15:25:21Z

dc.description.abstract

Background

Older age has been considered a relative contraindication to complex spinal procedures. Minimally invasive surgery (MIS) techniques to treat patients with adult spinal deformity (ASD) have emerged with the potential benefit of decreased approach-related morbidity.

Objective

To determine whether a minimal clinically important difference (MCID) could be achieved in patients ages ≥ 65 years with ASD who underwent MIS.

Methods

Multicenter database of patients who underwent MIS for ASD was queried. Outcome metrics assessed were Oswestry Disability Index (ODI) and visual analog scale (VAS) scores for back and leg pain. On the basis of published reports, MCID was defined as a positive change of 12.8 ODI, 1.2 VAS back pain, and 1.6 VAS leg pain.

Results

Forty-two patients were identified. Mean age was 70.3 years; 31 (73.8%) were women. Preoperatively, mean coronal curve, pelvic tilt, pelvic incidence to lumbar lordosis mismatch, and sagittal vertical axis were 35°, 24.6°, 14.2°, and 4.7 cm, respectively. Postoperatively, mean coronal curve, pelvic tilt, pelvic incidence to lumbar lordosis, and sagittal vertical axis were 18°, 25.4°, 11.9°, and 4.9 cm, respectively. A mean of 5.0 levels was treated posteriorly, and a mean of 4.0 interbody fusions was performed. Mean ODI improved from 47.1 to 25.1. Mean VAS back and leg pain scores improved from 6.8 and 5.9 to 2.7 and 2.7, respectively. Mean follow-up was 32.1 months. For ODI, 64.3% of patients achieved MCID. For VAS back and leg pain, 82.9% and 72.2%, respectively, reached MCID.

Conclusions

MCID represents the threshold at which patients feel a meaningful clinical improvement has occurred. Our study results suggest that the majority of elderly patients with modest ASD can achieve MCID with MIS.
dc.identifier

S1878-8750(15)01239-5

dc.identifier.issn

1878-8750

dc.identifier.issn

1878-8769

dc.identifier.uri

https://hdl.handle.net/10161/28477

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

World neurosurgery

dc.relation.isversionof

10.1016/j.wneu.2015.09.072

dc.subject

International Spine Study Group

dc.subject

Lumbar Vertebrae

dc.subject

Sacrum

dc.subject

Humans

dc.subject

Spinal Curvatures

dc.subject

Back Pain

dc.subject

Radiography

dc.subject

Treatment Outcome

dc.subject

Spinal Fusion

dc.subject

Cohort Studies

dc.subject

Age Factors

dc.subject

Recovery of Function

dc.subject

Databases, Factual

dc.subject

Aged

dc.subject

Female

dc.subject

Male

dc.subject

Minimally Invasive Surgical Procedures

dc.title

Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery?

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

168

pubs.end-page

172

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

86

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery_.pdf
Size:
1.64 MB
Format:
Adobe Portable Document Format