Javier Pizones1, Lucía Moreno-Manzanaro2, Alba Vila-Casademunt3, Nicomedes Fernández-Baíllo2, José Sánchez-Márquez2, Gloria Talavera2, Ibrahim Obeid4, Ahmet Alanay5, Frank Kleinstück6, Ferran Pellisé7, Francisco Javier Sánchez Perez-Grueso2. 1. Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain javierpizones@gmail.com. 2. Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain. 3. Spine Research Unit, Vall d'Hebron Institute of Research, Barcelona, Spain. 4. Spine Surgery Unit, Pellegrin University Hospital, Bordeaux, France. 5. Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. 6. Department of Orthopedics, Schulthess Klinik, Zurich, Switzerland. 7. Spine Surgery Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
Abstract
BACKGROUND: There is scarce information available about adult congenital spine deformity (ACSD) in the literature, especially its impact after the pediatric age. The aim was to define ACSD characteristics and to establish the drivers for surgical intervention. METHODS: Cross-sectional study of data collected in an adult deformity multicenter database. Only ACSD patients were included. Demographic and radiographic data, as well as patient-reported outcome measures, were assessed. Conservatively (C) vs surgically (S) treated patients were compared using Student t test, χ², and Mann-Whitney U test. RESULTS: Fifty-two patients were included. They were young adults (x = 37.7 years), mostly female (71%). Among them, 60% had single hemivertebrae (HV), 35% had multiple HV, and 5% had segmentation defects. Also, 75% had mainly coronal deformity (Cobb 62.5° ± 29.6) and 25% had sagittal deformity.Mean Oswestry Disability Index (ODI) was 29.6% ± 17 and mean Scoliosis Research Society 22-item survey (SRS-22) total score was 3.2 ± 0.8. Of note, mean SRS-22 self-image score was 2.8 ± 0.9 and 36-item Short Form Health Survey (SF-36) physical function score was 40.9 ± 11.Thirty patients were treated conservatively (C), whereas 22 patients underwent surgery (S). No differences were found regarding age, type or location of the deformity, comorbidities, or radiographic parameters. Operated patients had worse Core Outcome Measurement Index (COMI) back scores (C: 3.8 ± 2.4 vs S: 6.7 ± 2.4; P = 0.004); worse SRS-22 self-image (C: 3 ± 0.9 vs S: 2.5 ± 0.9; P = 0.047), and SRS-22 total scores (C: 3.4 ± 0.8 vs S: 2.9 ± 0.7; P = 0.01); worse SF-36 physical component summary (C: 43.3 ± 10.8 vs S: 36.7 ± 10.4; P = 0.048); and worse SF-36 physical role, function, and social function. CONCLUSION: Adult congenital deformity patients were mainly female young adults, with formation defects (HV), worried about their image and presenting some degree of functional impairment and pain. These symptoms were the essential drivers for surgery, rather than the radiographic deformity itself. CLINICAL RELEVANCE: One of the few studies describing the characteristics and clinical concerns of patients with congenital spinal deformities. LEVEL OF EVIDENCE: 3. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
BACKGROUND: There is scarce information available about adult congenital spine deformity (ACSD) in the literature, especially its impact after the pediatric age. The aim was to define ACSD characteristics and to establish the drivers for surgical intervention. METHODS: Cross-sectional study of data collected in an adult deformity multicenter database. Only ACSD patients were included. Demographic and radiographic data, as well as patient-reported outcome measures, were assessed. Conservatively (C) vs surgically (S) treated patients were compared using Student t test, χ², and Mann-Whitney U test. RESULTS: Fifty-two patients were included. They were young adults (x = 37.7 years), mostly female (71%). Among them, 60% had single hemivertebrae (HV), 35% had multiple HV, and 5% had segmentation defects. Also, 75% had mainly coronal deformity (Cobb 62.5° ± 29.6) and 25% had sagittal deformity.Mean Oswestry Disability Index (ODI) was 29.6% ± 17 and mean Scoliosis Research Society 22-item survey (SRS-22) total score was 3.2 ± 0.8. Of note, mean SRS-22 self-image score was 2.8 ± 0.9 and 36-item Short Form Health Survey (SF-36) physical function score was 40.9 ± 11.Thirty patients were treated conservatively (C), whereas 22 patients underwent surgery (S). No differences were found regarding age, type or location of the deformity, comorbidities, or radiographic parameters. Operated patients had worse Core Outcome Measurement Index (COMI) back scores (C: 3.8 ± 2.4 vs S: 6.7 ± 2.4; P = 0.004); worse SRS-22 self-image (C: 3 ± 0.9 vs S: 2.5 ± 0.9; P = 0.047), and SRS-22 total scores (C: 3.4 ± 0.8 vs S: 2.9 ± 0.7; P = 0.01); worse SF-36 physical component summary (C: 43.3 ± 10.8 vs S: 36.7 ± 10.4; P = 0.048); and worse SF-36 physical role, function, and social function. CONCLUSION: Adult congenital deformity patients were mainly female young adults, with formation defects (HV), worried about their image and presenting some degree of functional impairment and pain. These symptoms were the essential drivers for surgery, rather than the radiographic deformity itself. CLINICAL RELEVANCE: One of the few studies describing the characteristics and clinical concerns of patients with congenital spinal deformities. LEVEL OF EVIDENCE: 3. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
Authors: Steven D Glassman; Frank J Schwab; Keith H Bridwell; Stephen L Ondra; Sigurd Berven; Lawrence G Lenke Journal: Spine (Phila Pa 1976) Date: 2007-01-01 Impact factor: 3.468
Authors: Leah Y Carreon; Michael P Kelly; Charles H Crawford; Christine R Baldus; Steven D Glassman; Christopher I Shaffrey; Keith H Bridwell Journal: Spine Deform Date: 2018-01
Authors: Kimberly L Kesling; John E Lonstein; Francis Denis; Joseph H Perra; James D Schwender; Ensor E Transfeldt; Robert B Winter Journal: Spine (Phila Pa 1976) Date: 2003-02-01 Impact factor: 3.468