Takashi Fujishiro1,2, Louis Boissière3, Derek Thomas Cawley3, Daniel Larrieu3, Olivier Gille3, Jean-Marc Vital3, Ferran Pellisé4, Francisco Javier Sanchez Pérez-Grueso5, Frank Kleinstück6, Emre Acaroglu7, Ahmet Alanay8, Ibrahim Obeid3. 1. L'Institut de la Colonne Vertébrale, Bordeaux University Hospital, Place Amélie Raba-Léon, 33076, Bordeaux, France. ort167@osaka-med.ac.jp. 2. Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan. ort167@osaka-med.ac.jp. 3. L'Institut de la Colonne Vertébrale, Bordeaux University Hospital, Place Amélie Raba-Léon, 33076, Bordeaux, France. 4. Spine Surgery Unit, Hospital Universitario Val Hebron, Barcelona, Spain. 5. Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain. 6. Spine Center, Schulthess Klinik, Zurich, Switzerland. 7. Ankara Spine Center, Ankara, Turkey. 8. Spine Surgery Unit, Acibadem Maslak Hospital, Istanbul, Turkey.
Abstract
PURPOSE: We aimed to elucidate the factors for the decision-making process in the treatment of adult spinal deformity (ASD), including sagittal parameters, that impact health-related quality of life (HRQOL). METHODS: A multicenter prospective ASD database was retrospectively reviewed. The demographic data, HRQOL, and radiographic measures were analyzed using multivariate analyses in younger (≤ 50 years) and older (> 50 years) age groups. RESULTS: This study included 414 patients (134 surgical and 280 nonsurgical; mean age 30.7 years) in the younger age group and 575 patients (323 surgical and 252 nonsurgical; mean age 65.8 years) in the older age group. Worse HRQOL measures drove surgical treatment, both in younger and older patients. The SRS-22 self-image score was the most differentiating domain, both in the younger and older age groups, and an additional significant factor in the older age group was pain and disability. Coronal deformity drove surgical treatment for the younger age group; however, older surgical patients were less likely to have coronal malalignment. Sagittal parameters were associated with the decision-making process. Greater pelvic incidence minus lumbar lordosis mismatch in the younger age group and smaller lumbar lordosis index in the older age group were most correlated with the decision to undergo surgery. CONCLUSIONS: Aside from the HRQOL measures and coronal deformity, sagittal parameters were identified as significant factors for the decision-making process in the ASD population, and the lack of lumbar lordosis in relation to pelvic incidence was a strong driver to pursue surgical treatment. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: We aimed to elucidate the factors for the decision-making process in the treatment of adult spinal deformity (ASD), including sagittal parameters, that impact health-related quality of life (HRQOL). METHODS: A multicenter prospective ASD database was retrospectively reviewed. The demographic data, HRQOL, and radiographic measures were analyzed using multivariate analyses in younger (≤ 50 years) and older (> 50 years) age groups. RESULTS: This study included 414 patients (134 surgical and 280 nonsurgical; mean age 30.7 years) in the younger age group and 575 patients (323 surgical and 252 nonsurgical; mean age 65.8 years) in the older age group. Worse HRQOL measures drove surgical treatment, both in younger and older patients. The SRS-22 self-image score was the most differentiating domain, both in the younger and older age groups, and an additional significant factor in the older age group was pain and disability. Coronal deformity drove surgical treatment for the younger age group; however, older surgical patients were less likely to have coronal malalignment. Sagittal parameters were associated with the decision-making process. Greater pelvic incidence minus lumbar lordosis mismatch in the younger age group and smaller lumbar lordosis index in the older age group were most correlated with the decision to undergo surgery. CONCLUSIONS: Aside from the HRQOL measures and coronal deformity, sagittal parameters were identified as significant factors for the decision-making process in the ASD population, and the lack of lumbar lordosis in relation to pelvic incidence was a strong driver to pursue surgical treatment. These slides can be retrieved under Electronic Supplementary Material.
Authors: I Obeid; L Boissière; C Yilgor; D Larrieu; F Pellisé; A Alanay; E Acaroglu; F J Perez-Grueso; F Kleinstück; J M Vital; A Bourghli Journal: Eur Spine J Date: 2016-06-20 Impact factor: 3.134
Authors: Sigurd H Berven; Steven J Kamper; Niccole M Germscheid; Benny Dahl; Christopher I Shaffrey; Lawrence G Lenke; Stephen J Lewis; Kenneth M Cheung; Ahmet Alanay; Manabu Ito; David W Polly; Yong Qiu; Marinus de Kleuver Journal: Eur Spine J Date: 2017-08-05 Impact factor: 3.134
Authors: Keith H Bridwell; Sigurd Berven; Steven Glassman; Christopher Hamill; William C Horton; Lawrence G Lenke; Frank Schwab; Christine Baldus; Michael Shainline Journal: Spine (Phila Pa 1976) Date: 2007-09-15 Impact factor: 3.468
Authors: Brian J Neuman; Christine Baldus; Lukas P Zebala; Michael P Kelly; Christopher Shaffrey; Charles Edwards; Tyler Koski; Frank Schwab; Steven Glassman; Stefan Parent; Stephen Lewis; Lawrence G Lenke; Jacob M Buchowski; Justin S Smith; Charles H Crawford; Han Jo Kim; Virginia Lafage; Jon Lurie; Leah Carreon; Keith H Bridwell Journal: Spine (Phila Pa 1976) Date: 2016-03 Impact factor: 3.468
Authors: Jamie Terran; Frank Schwab; Christopher I Shaffrey; Justin S Smith; Pierre Devos; Christopher P Ames; Kai-Ming G Fu; Douglas Burton; Richard Hostin; Eric Klineberg; Munish Gupta; Vedat Deviren; Gregory Mundis; Robert Hart; Shay Bess; Virginie Lafage Journal: Neurosurgery Date: 2013-10 Impact factor: 4.654
Authors: S Richner-Wunderlin; A F Mannion; A Vila-Casademunt; F Pellise; M Serra-Burriel; B Seifert; E Aghayev; E Acaroglu; A Alanay; F J S Pérez-Grueso; I Obeid; F Kleinstück Journal: Eur Spine J Date: 2018-09-14 Impact factor: 3.134
Authors: Takashi Fujishiro; Louis Boissière; Derek Thomas Cawley; Daniel Larrieu; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre Acaroglu; Ahmet Alanay; Ibrahim Obeid Journal: Eur Spine J Date: 2019-03-07 Impact factor: 3.134
Authors: Takashi Fujishiro; Louis Boissière; Derek Thomas Cawley; Daniel Larrieu; Olivier Gille; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre Acaroglu; Ahmet Alanay; Ibrahim Obeid Journal: Eur Spine J Date: 2019-07-17 Impact factor: 3.134
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: Kenny Yat Hong Kwan; J Naresh-Babu; Wilco Jacobs; Marinus de Kleuver; David W Polly; Caglar Yilgor; Yabin Wu; Jong-Beom Park; Manabu Ito; Miranda L van Hooff Journal: Neurosurgery Date: 2021-05-13 Impact factor: 4.654