Tamir Ailon1, Justin S Smith2, Christopher I Shaffrey2, Han Jo Kim3, Gregory Mundis4, Munish Gupta5, Eric Klineberg6, Frank Schwab3, Virginie Lafage3, Renaud Lafage3, Peter Passias7, Themistocles Protopsaltis7, Brian Neuman8, Alan Daniels9, Justin K Scheer10, Alex Soroceanu11, Robert Hart12, Rick Hostin13, Douglas Burton14, Vedat Deviren15, Todd J Albert3, K Daniel Riew16, Shay Bess17, Christopher P Ames18. 1. Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. 2. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia. 3. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York. 4. Department of Orthopaedic Surgery, San Diego Center for Spinal Disorders, La Jolla, California. 5. Department of Orthopaedic Surgery, Washington University, St Louis, Missouri. 6. Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California. 7. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York. 8. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland. 9. Department of Orthopaedic Surgery, Brown University Alpert Medical School, Providence, Rhode Island. 10. Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois. 11. Department of Orthopaedics, University of Calgary, Calgary, Alberta, Canada. 12. Swedish Neuroscience Institute, Seattle, Washington. 13. Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, Texas. 14. Department of Orthopaedics, University of Kansas Medical Center, Kansas City, Kansas. 15. Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, California. 16. Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York. 17. Department of Orthopaedic Surgery, Denver International Spine Center, Denver, Colorado. 18. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
Abstract
BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients. OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL. METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed. RESULTS: Of 77 ACD patients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomy was performed in 24% of patients. One year following surgery, ACD patients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014). CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.
BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients. OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL. METHODS: We conducted a prospective cohort study of surgically treated ACDpatients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed. RESULTS: Of 77 ACDpatients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomy was performed in 24% of patients. One year following surgery, ACDpatients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014). CONCLUSION: Based on a prospective multicenter series of ACDpatients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.
Authors: Alexander B Dru; Dennis Timothy Lockney; Sasha Vaziri; Matthew Decker; Adam J Polifka; W Christopher Fox; Daniel J Hoh Journal: Neurospine Date: 2019-09-30
Authors: Peter Gust Passias; Samantha R Horn; Virginie Lafage; Renaud Lafage; Justin S Smith; Breton G Line; Themistocles S Protopsaltis; Alex Soroceanu; Cole Bortz; Frank A Segreto; Waleed Ahmad; Sara Naessig; Katherine E Pierce; Avery E Brown; Haddy Alas; Han Jo Kim; Alan H Daniels; Eric O Klineberg; Douglas C Burton; Robert A Hart; Frank J Schwab; Shay Bess; Christopher I Shaffrey; Christopher P Ames Journal: J Craniovertebr Junction Spine Date: 2021-03-04
Authors: Katherine E Pierce; Peter Gust Passias; Avery E Brown; Cole A Bortz; Haddy Alas; Renaud Lafage; Oscar Krol; Dean Chou; Douglas C Burton; Breton Line; Eric Klineberg; Robert Hart; Jeffrey Gum; Alan Daniels; Kojo Hamilton; Shay Bess; Themistocles Protopsaltis; Christopher Shaffrey; Frank A Schwab; Justin S Smith; Virginie Lafage; Christopher Ames Journal: J Craniovertebr Junction Spine Date: 2021-09-08
Authors: Han Jo Kim; Yu-Cheng Yao; Christopher I Shaffrey; Justin S Smith; Michael P Kelly; Munish Gupta; Todd J Albert; Themistocles S Protopsaltis; Gregory M Mundis; Peter Passias; Eric Klineberg; Shay Bess; Virginie Lafage; Christopher P Ames Journal: Global Spine J Date: 2020-11-23
Authors: Peter Gust Passias; Avery E Brown; Haddy Alas; Katherine E Pierce; Cole A Bortz; Bassel Diebo; Renaud Lafage; Virginie Lafage; Douglas C Burton; Robert Hart; Han Jo Kim; Shay Bess; Kevin Moattari; Rachel Joujon-Roche; Oscar Krol; Tyler Williamson; Peter Tretiakov; Bailey Imbo; Themistocles S Protopsaltis; Christopher Shaffrey; Frank Schwab; Robert Eastlack; Breton Line; Eric Klineberg; Justin Smith; Christopher Ames Journal: J Craniovertebr Junction Spine Date: 2021-12-11