• Rajiv Saigal, Darryl Lau, Sigurd H Berven, Leah Carreon, Mark B Dekutoski, Khaled M Kebaish, Yong Qiu, Yukihiro Matsuyama, Michael Kelly, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Stephen J Lewis, CheungKenneth M CKMCDepartment of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China., Christopher I Shaffrey, Michael G Fehlings, Lawrence G Lenke, Christopher P Ames, and AOSpine Knowledge Forum Deformity.
• Department of Neurosurgery and Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA.
• Spine. 2021 Apr 1; 46 (7): E450E457E450-E457.

Study DesignInternational, multicenter, prospective, longitudinal observational cohort.ObjectiveTo assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.Summary Of Background DataAdult spinal deformity surgery is associated with high morbidity, including risk of new postoperative motor deficit. It is unclear what effect new motor deficit has on Health-related Quality of Life scores (HRQOL) scores.MethodsAdult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb more than 80°, C7-L2 curve apex, and any patient undergoing three column osteotomy. American Spinal Injury Association (ASIA) scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.ResultsTwo hundred seventy two complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower extremity motor score (LEMS). Mean HRQOL changes at 6 weeks and 2 years compared with pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and -4.7 at 2 years), SF-36v2 physical (-4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and -12.1 at 2 years), SF-36v2 physical (-1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (-0.6 at 6 weeks and -16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).ConclusionIn the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared with pre-op baseline.Level of Evidence: 3.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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