Comparison of Structural Disease Burden to Health-related Quality of Life Scores in 264 Adult Spinal Deformity Patients With 2-Year Follow-up: Novel Insights into Drivers of Disability.

dc.contributor.author

Bakhsheshian, Joshua

dc.contributor.author

Scheer, Justin K

dc.contributor.author

Gum, Jeffrey L

dc.contributor.author

Horner, Lance

dc.contributor.author

Hostin, Richard

dc.contributor.author

Lafage, Virginie

dc.contributor.author

Bess, Shay

dc.contributor.author

Protopsaltis, Themistocles S

dc.contributor.author

Burton, Douglas C

dc.contributor.author

Keefe, Malla

dc.contributor.author

Hart, Robert A

dc.contributor.author

Mundis, Gregory M

dc.contributor.author

Shaffrey, Christopher I

dc.contributor.author

Schwab, Frank

dc.contributor.author

Smith, Justin S

dc.contributor.author

Ames, Christopher P

dc.contributor.author

International Spine Study Group (ISSG)

dc.date.accessioned

2023-07-09T21:55:02Z

dc.date.available

2023-07-09T21:55:02Z

dc.date.issued

2017-03

dc.date.updated

2023-07-09T21:55:01Z

dc.description.abstract

Study design

This is a review of a prospective multicenter database.

Objective

To investigate the relationship between preoperative disability and sagittal deformity in patients with high Oswestry Disability Index (ODI) and no sagittal malalignment, or low ODI and high sagittal malalignment.

Summary of background data

The relationship between ODI and sagittal malalignment varies between each adult spinal deformity (ASD) patient.

Methods

A prospective multicenter database of 365 patients with ASD undergoing surgical reconstruction was analyzed. Inclusion criteria entailed: age 18 years or above and the presence of spinal deformity as defined by a coronal Cobb angle≥20 degrees, sagittal vertical axis (SVA)≥5 cm, pelvic tilt (PT) angle≥25 degrees, or thoracic kyphosis≥60 degrees. Radiographic and health-related quality of life (HRQOL) variables were examined and compared, preoperatively and at 2-year postoperative follow-up. Group 1 (low disability high sagittal-LDHS) consisted of ODI<40 and SVA≥5 cm or PT≥25 degrees or pelvic incidence-lumbar lordosis≥11 degrees and group 2 (high disability low sagittal-HDLS) consisted of ODI>40 and SVA<5 cm and PT<25 degrees and pelvic incidence-lumbar lordosis<11 degrees.

Results

Of 264 patients with follow-up, 58 (22.0%) patients were included in LDHS and 30 (11.4%) were included in HDLS. Both groups had similar demographics and preoperative coronal angles. HDLS had worse baseline HRQOL for all measures (P<0.05) except leg and back pain. HDLS had a higher rate of self-reported leg weakness, arthritis, depression and neurological disorder. Both groups had similar 2-year improvements in HRQOL (P>0.05), except only HDLS had a significant Scoliosis Research Society Mental improvement and a significantly higher rate of reaching minimal clinically important differences in Scoliosis Research Society Mental scores (P<0.05).

Conclusions

There is an association of worse baseline HRQOL measures, weakness, arthritis, and mental disease in HDLS. Furthermore, HDLS patients demonstrated similar improvements to LDHS. However, HDLS had greater improvements in the mental domains, perhaps indicating the responsiveness of the mental disability to surgical treatment.

Level of evidence

Level III.
dc.identifier.issn

2380-0186

dc.identifier.issn

2380-0194

dc.identifier.uri

https://hdl.handle.net/10161/28403

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Clinical spine surgery

dc.relation.isversionof

10.1097/bsd.0000000000000470

dc.subject

International Spine Study Group (ISSG)

dc.subject

Humans

dc.subject

Spinal Curvatures

dc.subject

Radiography

dc.subject

Disability Evaluation

dc.subject

Treatment Outcome

dc.subject

Severity of Illness Index

dc.subject

Statistics, Nonparametric

dc.subject

Longitudinal Studies

dc.subject

Braces

dc.subject

Quality of Life

dc.subject

Adult

dc.subject

Aged

dc.subject

Middle Aged

dc.subject

Disabled Persons

dc.subject

Female

dc.subject

Male

dc.subject

Plastic Surgery Procedures

dc.title

Comparison of Structural Disease Burden to Health-related Quality of Life Scores in 264 Adult Spinal Deformity Patients With 2-Year Follow-up: Novel Insights into Drivers of Disability.

dc.type

Journal article

duke.contributor.orcid

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

pubs.begin-page

E124

pubs.end-page

E131

pubs.issue

2

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

30

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Comparison of Structural Disease Burden to Health-related Quality of Life Scores in 264 Adult Spinal Deformity Patients With 2-Year Follow-up Novel Insights into Drivers of Disability..pdf
Size:
325.54 KB
Format:
Adobe Portable Document Format