Jeffrey L Gum1, Keith H Bridwell, Lawrence G Lenke, David B Bumpass, Patrick A Sugrue, Isaac O Karikari, Leah Y Carreon. 1. *Norton Leatherman Spine Center, Louisville, KY †Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO ‡Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL; and §Department of Surgery, Division of Neurosurgery, Duke University Medical Center, Durham, NC.
Abstract
STUDY DESIGN: Longitudinal cohort. OBJECTIVE: To evaluate the relationship between Scoliosis Research Society-22R (SRS22-R) domains and satisfaction with management in patients who underwent surgical correction for adult spine deformity. SUMMARY OF BACKGROUND DATA: The SRS-22R is used to measure clinical outcomes in adult spine deformity patients. The relationship between patient satisfaction and SRS-22R domain scores, the Oswestry Disability Index (ODI) and radiographical parameters has not been reported at 5-year follow-up. METHODS: 135 patients with adult spinal deformity at a single institution who underwent a posterior spinal fusion of 5 levels or more to the sacrum and had complete SRS-22R pre- and minimum 5-year postoperative were identified. Wilcoxon tests were used to compare preoperative and 5-year postoperative scores. Spearman correlations were used to evaluate associations between the 5-year SRS-22R Satisfaction score and changes in SRS-22R domain scores, SubScore (SRS-22R Total-Satisfaction), ODI, and radiographical parameters. RESULTS: There were 125 females and 10 males with a mean BMI of 26.6 kg/m and mean age of 53.6 years. There were 74 primary and 61 revision surgeries with a mean 9.9 levels fused and mean follow-up of 67 months. There was a statistically significant improvement between paired pre- and 5-year postop SRS-22R domain scores and most radiographical parameters, commonly P ≤ 0.001. The majority of patients had an SRS-22R Satisfaction score of 3.0 or more (88%) or 4.0 or more (67%), consistent with a moderate ceiling effect. Correlations for SRS-22R domain scores were all statistically significant and either weak [Mental (0.26), Activity (0.27), Pain (0.35), or moderate (Appearance (0.59))]. SRS-22R SubScore (0.54) and ODI (0.43) also had a moderate correlation. Correlations for all radiographical and operative parameters were either very weak or weak. CONCLUSION: SRS-22R Appearance, SubScore, and ODI correlate most with patient satisfaction in adult deformity patients undergoing 5 or more level fusion to the sacrum at 5-year follow-up. LEVEL OF EVIDENCE: 2.
STUDY DESIGN: Longitudinal cohort. OBJECTIVE: To evaluate the relationship between Scoliosis Research Society-22R (SRS22-R) domains and satisfaction with management in patients who underwent surgical correction for adult spine deformity. SUMMARY OF BACKGROUND DATA: The SRS-22R is used to measure clinical outcomes in adult spine deformitypatients. The relationship between patient satisfaction and SRS-22R domain scores, the Oswestry Disability Index (ODI) and radiographical parameters has not been reported at 5-year follow-up. METHODS: 135 patients with adult spinal deformity at a single institution who underwent a posterior spinal fusion of 5 levels or more to the sacrum and had complete SRS-22R pre- and minimum 5-year postoperative were identified. Wilcoxon tests were used to compare preoperative and 5-year postoperative scores. Spearman correlations were used to evaluate associations between the 5-year SRS-22R Satisfaction score and changes in SRS-22R domain scores, SubScore (SRS-22R Total-Satisfaction), ODI, and radiographical parameters. RESULTS: There were 125 females and 10 males with a mean BMI of 26.6 kg/m and mean age of 53.6 years. There were 74 primary and 61 revision surgeries with a mean 9.9 levels fused and mean follow-up of 67 months. There was a statistically significant improvement between paired pre- and 5-year postop SRS-22R domain scores and most radiographical parameters, commonly P ≤ 0.001. The majority of patients had an SRS-22R Satisfaction score of 3.0 or more (88%) or 4.0 or more (67%), consistent with a moderate ceiling effect. Correlations for SRS-22R domain scores were all statistically significant and either weak [Mental (0.26), Activity (0.27), Pain (0.35), or moderate (Appearance (0.59))]. SRS-22R SubScore (0.54) and ODI (0.43) also had a moderate correlation. Correlations for all radiographical and operative parameters were either very weak or weak. CONCLUSION: SRS-22R Appearance, SubScore, and ODI correlate most with patient satisfaction in adult deformitypatients undergoing 5 or more level fusion to the sacrum at 5-year follow-up. LEVEL OF EVIDENCE: 2.
Authors: Kazunori Hayashi; Louis Boissière; Fernando Guevara-Villazón; Daniel Larrieu; Anouar Bourghli; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sánchez Pérez-Grueso; Frank Kleinstück; Emre Acaroğlu; Ahmet Alanay; Hiroaki Nakamura; Ibrahim Obeid Journal: Eur Spine J Date: 2019-10-31 Impact factor: 3.134
Authors: Daniel Sciubba; Amit Jain; Khaled M Kebaish; Brian J Neuman; Alan H Daniels; Peter G Passias; Han J Kim; Themistocles S Protopsaltis; Justin K Scheer; Justin S Smith; Kojo Hamilton; Shay Bess; Eric O Klineberg; Christopher P Ames Journal: Global Spine J Date: 2019-12-26