Change in classification grade by the SRS-Schwab Adult Spinal Deformity Classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment.

dc.contributor.author

Smith, Justin S

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Klineberg, Eric

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Schwab, Frank

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Shaffrey, Christopher I

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Moal, Bertrand

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Ames, Christopher P

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Hostin, Richard

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Fu, Kai-Ming G

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Burton, Douglas

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Akbarnia, Behrooz

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Gupta, Munish

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Hart, Robert

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Bess, Shay

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Lafage, Virginie

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International Spine Study Group

dc.date.accessioned

2023-08-29T23:38:49Z

dc.date.available

2023-08-29T23:38:49Z

dc.date.issued

2013-09

dc.date.updated

2023-08-29T23:38:48Z

dc.description.abstract

Study design

Multicenter, prospective, consecutive series.

Objective

To evaluate responsiveness of the Scoliosis Research Society (SRS)-Schwab adult spinal deformity (ASD) classification to changes in health-related quality of life (HRQOL) after treatment for ASD.

Summary of background data

Ideally, a classification system should describe and be responsive to changes in a disease state. We hypothesized that the SRS-Schwab classification is responsive to changes in HRQOL measures after treatment for ASD.

Methods

A multicenter, prospective, consecutive series from the International Spine Study Group.

Inclusion criteria

ASD, age more than 18, operative or nonoperative treatment, baseline and 1-year radiographs, and HRQOL measures (Oswestry Disability Index [ODI], SRS-22, Short Form [SF]-36). The SRS-Schwab classification includes a curve descriptor and 3 sagittal spinopelvic modifiers (sagittal vertical axis [SVA], pelvic tilt, pelvic incidence/lumbar lordosis [PI-LL] mismatch). Changes in modifiers at 1 year were assessed for impact on HRQOL from pretreatment values based on minimal clinically important differences.

Results

Three hundred forty-one patients met criteria (mean age = 54; 85% females; 177 operative and 164 nonoperative). Change in pelvic tilt modifier at 1-year follow-up was associated with changes in ODI and SRS-22 (total and appearance scores) (P ≤ 0.034). Change in SVA modifier at 1 year was associated with changes in ODI, SF-36 physical component score, and SRS-22 (total, activity, and appearance scores) (P ≤ 0.037). Change in PI-LL modifier at 1 year was associated with changes in SF-36 physical component score and SRS-22 (total, activity, and appearance scores) (P ≤ 0.03). Patients with improvement of pelvic tilt, SVA, or PI-LL modifiers were significantly more likely to achieve minimal clinically important difference for ODI, SF-36 physical component score (SVA and PI-LL only), SRS activity, and SRS pain (PI-LL only).

Conclusion

The SRS-Schwab classification provides a validated system to evaluate ASD, and the classification components correlate with HRQOL measures. This study demonstrates that the classification modifiers are responsive to changes in disease state and reflect significant changes in patient-reported outcomes.

Level of evidence

3.
dc.identifier.issn

0362-2436

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1528-1159

dc.identifier.uri

https://hdl.handle.net/10161/28825

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Spine

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10.1097/brs.0b013e31829ec563

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International Spine Study Group

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Humans

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Scoliosis

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Treatment Outcome

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Follow-Up Studies

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Prospective Studies

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Reproducibility of Results

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Predictive Value of Tests

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Health Status

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Quality of Life

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Adult

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Aged

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Middle Aged

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Female

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Male

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Surveys and Questionnaires

dc.title

Change in classification grade by the SRS-Schwab Adult Spinal Deformity Classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment.

dc.type

Journal article

duke.contributor.orcid

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

pubs.begin-page

1663

pubs.end-page

1671

pubs.issue

19

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

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Neurosurgery

pubs.publication-status

Published

pubs.volume

38

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