D T Cawley1,2, M Takemoto3, L Boissiere4, D Larrieu4, D C Kieser5, T Fujishiro6, K Hayashi7, A Bourghli8, C Yilgor9, A Alanay9, F J Perez Grueso10, F Pelisse11, F Kleinstück12, J M Vital4, I Obeid4. 1. Institut de La Colonne Vertébrale, CHU Pellegrin, Bordeaux, France. derekcawley@hotmail.com. 2. Mater Private Hospital, Dublin 1, Ireland. derekcawley@hotmail.com. 3. Kyoto City Hospital, Kyoto, Japan. 4. Institut de La Colonne Vertébrale, CHU Pellegrin, Bordeaux, France. 5. Christchurch School of Medicine, University of Otago, Dunedin, New Zealand. 6. Osaka Medical College, Takatsuki-shi, Osaka, Japan. 7. Osaka City University Graduate School of Medicine, Juso Hospital, Osaka, Japan. 8. Kingdom Hospital, Riyadh, Saudi Arabia. 9. Acibadem University School of Medicine, Istanbul, Turkey. 10. Hospital Universitario La Paz, Madrid, Spain. 11. Hospital Universitario Val Hebron, Barcelona, Spain. 12. Schulthess Klinik, Zurich, Switzerland.
Abstract
PURPOSE: Objectives in scoliosis corrective surgery include restoration of normal sagittal and coronal parameters to achieve patient satisfaction. HRQLs improvements remain limited after corrective surgery. The aim of this study was to evaluate the HRQL subclass variability specific to the sagittal and coronal correction in adult scoliosis surgery. METHODS: This multi-centre prospective analysis of consecutive adult spinal deformity (ASD) patients, from five European centres, only included multilevel instrumentation for scoliosis. d-(delta) values for each parameter represented pre to post-operative changes. Parameters included demographics, baseline, 1- and 2-year. HRQL outcomes (Oswestry disability index (ODI), Scoliosis Research Society (SRS)-22 and Short Form (SF36)), sagittal correction including relative spinopelvic alignment (dRSA) and coronal correction including major Cobb (dCobb) angles. RESULTS: A total of 353 patients reached 1-year and 2-year follow up. All HRQL total scores significantly improved postoperatively, including ODI, SRS-22 and SF36. HRQL subclasses which displayed persistent improvements correlated to dRSA included sex-life, self-image, fatigue, vitality, social functioning. The only HRQL subclass improvement that correlated with dCobb was self-image. CONCLUSION: Adult scoliosis surgery improves overall HRQL, having a minimal effect on each variable. Importantly, greater coronal deformity correction affects only greater self-image scores, whereas with greater sagittal correction there are many greater HRQL sub-class impacts. Correction and restoration of coronal balance is one of the surgical goals in adult scoliosis but the degree to which Cobb angle is corrected, apart from self-image, does not correlate with gains in sub-classes of HRQL. These results need to be taken into account when planning surgery.
PURPOSE: Objectives in scoliosis corrective surgery include restoration of normal sagittal and coronal parameters to achieve patient satisfaction. HRQLs improvements remain limited after corrective surgery. The aim of this study was to evaluate the HRQL subclass variability specific to the sagittal and coronal correction in adult scoliosis surgery. METHODS: This multi-centre prospective analysis of consecutive adult spinal deformity (ASD) patients, from five European centres, only included multilevel instrumentation for scoliosis. d-(delta) values for each parameter represented pre to post-operative changes. Parameters included demographics, baseline, 1- and 2-year. HRQL outcomes (Oswestry disability index (ODI), Scoliosis Research Society (SRS)-22 and Short Form (SF36)), sagittal correction including relative spinopelvic alignment (dRSA) and coronal correction including major Cobb (dCobb) angles. RESULTS: A total of 353 patients reached 1-year and 2-year follow up. All HRQL total scores significantly improved postoperatively, including ODI, SRS-22 and SF36. HRQL subclasses which displayed persistent improvements correlated to dRSA included sex-life, self-image, fatigue, vitality, social functioning. The only HRQL subclass improvement that correlated with dCobb was self-image. CONCLUSION: Adult scoliosis surgery improves overall HRQL, having a minimal effect on each variable. Importantly, greater coronal deformity correction affects only greater self-image scores, whereas with greater sagittal correction there are many greater HRQL sub-class impacts. Correction and restoration of coronal balance is one of the surgical goals in adult scoliosis but the degree to which Cobb angle is corrected, apart from self-image, does not correlate with gains in sub-classes of HRQL. These results need to be taken into account when planning surgery.
Entities:
Keywords:
Adult spinal deformity; Coronal; Deformity correction; Health related quality of life; Scoliosis
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: Anouar Bourghli; Louis Boissière; David Kieser; Daniel Larrieu; Javier Pizones; Ahmet Alanay; Ferran Pellise; Franck Kleinstück; Ibrahim Obeid Journal: Neurospine Date: 2021-10-21