Patients with Adult Spinal Deformity with Previous Fusions Have an Equal Chance of Reaching Substantial Clinical Benefit Thresholds in Health-Related Quality of Life Measures but Do Not Reach the Same Absolute Level of Improvement

World Neurosurgery
Tamir AilonInternational Spine Study Group

Abstract

Substantial clinical benefit (SCB) represents a threshold above which patients recognize substantial improvement and represents a rational target for defining clinical success. In adult spinal deformity (ASD) surgery, previous fusions may impact outcomes after deformity correction. To investigate the impact of previous spinal fusion on the likelihood of reaching SCB thresholds for 2-year health-related quality of life (HRQOL) after ASD surgery. We conducted a retrospective review comparing baseline demographic, HRQOL, and radiographic features for patients with ASD undergoing primary versus revision procedures. The primary outcome measure was reaching SCB threshold in Oswestry Disability Index (ODI), SF-36 Physical Component Summary (PCS), and back and leg pain (numeric rating scale). Secondary outcomes included absolute and change scores in ODI, PCS, and back and leg pain. In total, 332 patients achieved 2-year follow-up (228 primary; 104 revision cases). Those undergoing revision surgery had similar demographic features (age 58.3/55.9, female 80.8%/82.9%) to patients undergoing primary surgery. They had worse baseline HRQOL (ODI 48.5/41.2, PCS 29.5/33.4, back 7.5/7.0, and leg pain 4.9/4.3; P < 0.001) and radiographic deformit...Continue Reading

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Sep 18, 2015·Neurosurgery·Tamir AilonChristopher P Ames

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Citations

Feb 26, 2019·The Journal of Bone and Joint Surgery. American Volume·Michael P KellyKeith H Bridwell
Jun 25, 2019·Clinical Orthopaedics and Related Research·Walter F Krengel

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