Sagittal age-adjusted score (SAAS) for adult spinal deformity (ASD) more effectively predicts surgical outcomes and proximal junctional kyphosis than previous classifications.
| dc.contributor.author | Lafage, Renaud | |
| dc.contributor.author | Smith, Justin S | |
| dc.contributor.author | Elysee, Jonathan | |
| dc.contributor.author | Passias, Peter | |
| dc.contributor.author | Bess, Shay | |
| dc.contributor.author | Klineberg, Eric | |
| dc.contributor.author | Kim, Han Jo | |
| dc.contributor.author | Shaffrey, Christopher | |
| dc.contributor.author | Burton, Douglas | |
| dc.contributor.author | Hostin, Richard | |
| dc.contributor.author | Mundis, Gregory | |
| dc.contributor.author | Ames, Christopher | |
| dc.contributor.author | Schwab, Frank | |
| dc.contributor.author | Lafage, Virginie | |
| dc.contributor.author | International Spine Study Group (ISSG) | |
| dc.date.accessioned | 2023-06-16T15:20:30Z | |
| dc.date.available | 2023-06-16T15:20:30Z | |
| dc.date.issued | 2022-01 | |
| dc.date.updated | 2023-06-16T15:20:30Z | |
| dc.description.abstract | BackgroundSeveral methodologies have been proposed to determine ideal ASD sagittal spinopelvic alignment (SRS-Schwab classification) global alignment and proportion (GAP) score, patient age-adjusted alignment). A recent study revealed the ability and limitations of these methodologies to predict PJK. The aim of the study was to develop a new approach, inspired by SRS classification, GAP score, and age-alignment to improve the evaluation of the sagittal plane.MethodA multi-center ASD database was retrospectively evaluated for surgically treated ASD patients with complete fusion of the lumbar spine, and minimum 2 year follow-up. The Sagittal age-adjusted score (SAAS) methodology was created by assigning numerical values to the difference between each patient's postoperative sagittal alignment and ideal alignment defined by previously reported age generational norms for PI-LL, PT, and TPA. Postoperative HRQOL and PJK severity between each SAAS categories were evaluated.Results409 of 667 (61.3%) patients meeting inclusion criteria were evaluated. At 2 year SAAS score showed that 27.0% of the patients were under-corrected, 51.7% over-corrected, and 21.3% matched their age-adjusted target. SAAS score increased as PJK worsened (from SAAS = 0.2 for no-PJK, to 4.0 for PJF, p < 0.001). Post-operatively, HRQOL differences between SAAS groups included ODI, SRS pain, and SRS total.ConclusionInspired by SRS classification, the concept of the GAP score, and age-adjusted alignment targets, the results demonstrated significant association with PJK and patient reported outcomes. With a lower rate of failure and better HRQOL, the SAAS seems to represent a "sweet spot" to optimize HRQOL while mitigating the risk of mechanical complications. | |
| dc.identifier | 10.1007/s43390-021-00397-1 | |
| dc.identifier.issn | 2212-134X | |
| dc.identifier.issn | 2212-1358 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Springer Science and Business Media LLC | |
| dc.relation.ispartof | Spine deformity | |
| dc.relation.isversionof | 10.1007/s43390-021-00397-1 | |
| dc.subject | International Spine Study Group (ISSG) | |
| dc.subject | Lumbar Vertebrae | |
| dc.subject | Humans | |
| dc.subject | Kyphosis | |
| dc.subject | Treatment Outcome | |
| dc.subject | Spinal Fusion | |
| dc.subject | Retrospective Studies | |
| dc.subject | Adult | |
| dc.title | Sagittal age-adjusted score (SAAS) for adult spinal deformity (ASD) more effectively predicts surgical outcomes and proximal junctional kyphosis than previous classifications. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Passias, Peter|0000-0002-1479-4070|0000-0003-2635-2226 | |
| duke.contributor.orcid | Shaffrey, Christopher|0000-0001-9760-8386 | |
| pubs.begin-page | 121 | |
| pubs.end-page | 131 | |
| pubs.issue | 1 | |
| 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 | 10 |
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