Sayf S A Faraj1, Toon F M Boselie2, Alba Vila-Casademunt3, Marinus de Kleuver4, Roderick M Holewijn5, Ibrahim Obeid6, Emre Acaroglu7, Ahmet Alanay8, Frank Kleinstück9, Francisco S Pérez-Grueso10, Ferran Pellisé3. 1. Orthopedics, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands. Electronic address: Sayf.Faraj@radboudumc.nl. 2. Neurosurgery, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands. 3. Spine Surgery Unit, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain. 4. Orthopedics, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands. 5. Orthopaedic Surgery, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. 6. Spine Unit, Bordeaux University Hospital, 12 rude Dubernat, Talence 33404, Bordeaux, France. 7. Ankara Spine Center, Iran Caddesi, 45/2, Kavaklidere, Ankara, Turkey. 8. Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, İçerenköy Mahallesi, Kayışdağı Cd. No: 32, 34752, Ataşehir/Istanbul, Turkey. 9. Schultess Clinic, Lengghalde 2, 8008 Zurich, Switzerland. 10. Spine Surgery Unit, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
Abstract
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVES: The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) using a novel radiographic software tool. SUMMARY OF BACKGROUND DATA: Recent studies have demonstrated that in ADS, sagittal and coronal plane deformity are weakly to moderately associated with HRQOL, disability, and pain. However, as ADS is a three-dimensional spinal deformity, the impact of axial malalignment on HRQOL is yet to be determined. METHODS: A total of 74 ADS patients were enrolled. HRQOL measures included the Short Form-36v2 (SF-36v2) and Scoliosis Research Society questionnaire (SRS-22r). Disability and pain measures included the Oswestry Disability Index (ODI) and numeric rating scale back and leg pain. Radiographic measures included Cobb angle (CA), sagittal spinopelvic parameters, lateral and anteroposterior (AP) translation of the apical vertebra. The amount of apical vertebral axial rotation was measured on digital AP radiograph images using a novel software technology. Subjects were stratified into four clinical groups based on the degree of apical vertebral axial rotation. RESULTS: Apical vertebral axial rotation showed no association with lateral (r = 0.21; p = .15) and AP (r = 0.08, p = .80) translation of the apical vertebra. A significant moderate association was found between apical vertebral axial rotation and Cobb angle (r = 0.57; p < .05). Patients in the group with the highest degree of apical vertebral axial rotation reported significantly worse ODI and SRS-22r Subtotal and Pain scores (p < .05), irrespective of sagittal spinopelvic parameters. CONCLUSIONS: This is the first study that reports on the association between apical vertebral axial rotation and pretreatment HRQOL, disability, and pain in ADS. This study suggests that increased apical vertebral axial rotation is associated with suboptimal pretreatment health status scores. LEVEL OF EVIDENCE: Level III.
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVES: The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) using a novel radiographic software tool. SUMMARY OF BACKGROUND DATA: Recent studies have demonstrated that in ADS, sagittal and coronal plane deformity are weakly to moderately associated with HRQOL, disability, and pain. However, as ADS is a three-dimensional spinal deformity, the impact of axial malalignment on HRQOL is yet to be determined. METHODS: A total of 74 ADS patients were enrolled. HRQOL measures included the Short Form-36v2 (SF-36v2) and Scoliosis Research Society questionnaire (SRS-22r). Disability and pain measures included the Oswestry Disability Index (ODI) and numeric rating scale back and leg pain. Radiographic measures included Cobb angle (CA), sagittal spinopelvic parameters, lateral and anteroposterior (AP) translation of the apical vertebra. The amount of apical vertebral axial rotation was measured on digital AP radiograph images using a novel software technology. Subjects were stratified into four clinical groups based on the degree of apical vertebral axial rotation. RESULTS:Apical vertebral axial rotation showed no association with lateral (r = 0.21; p = .15) and AP (r = 0.08, p = .80) translation of the apical vertebra. A significant moderate association was found between apical vertebral axial rotation and Cobb angle (r = 0.57; p < .05). Patients in the group with the highest degree of apical vertebral axial rotation reported significantly worse ODI and SRS-22r Subtotal and Pain scores (p < .05), irrespective of sagittal spinopelvic parameters. CONCLUSIONS: This is the first study that reports on the association between apical vertebral axial rotation and pretreatment HRQOL, disability, and pain in ADS. This study suggests that increased apical vertebral axial rotation is associated with suboptimal pretreatment health status scores. LEVEL OF EVIDENCE: Level III.