• Hideyuki Arima, Tomohiko Hasegawa, Yu Yamato, Daisuke Togawa, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Shin Oe, Yuki Mihara, Hiroki Ushirozako, Tomohiro Yamada, Yuh Watanabe, Koichiro Ide, Keiichi Nakai, and Yukihiro Matsuyama.
• Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan.
• Spine. 2021 Mar 15; 46 (6): E384-E391.

Study DesignRetrospective longitudinal cohort study.ObjectiveThis study aimed to elucidate factors affecting the likelihood of achieving minimum clinically important difference (MCID) to patient-reported outcomes defined by the Scoliosis Research Society-22r (SRS-22r) among patients with adult spinal deformity (ASD) who underwent extensive corrective fusion surgery from the thoracic spine to the pelvis.Summary Of Background DataAchieving MCID for SRS-22r parameters was a measure of surgical efficacy. Patient characteristics and surgical and radiographic factors that affect the likelihood of achieving MCID for SRS-22r parameters are unknown.MethodsData from patients with ASD who underwent extensive corrective fusion surgery from the thoracic spine to the pelvis during 2010 to 2016 were retrospectively reviewed. Data from a total of 167 patients with ≥2 years of follow-up were included. Multivariate analysis was used to investigate factors associated with the likelihood of achieving MCID for each of the SRS-22r domains (Function, Pain, Subtotal) 2 years after surgery. The following MCID values were used: 0.90 for Function, 0.85 for Pain, and 1.05 for the Subtotal.ResultsMCID achievement rate was 36.5% for Function, 46.1% for Pain, and 44.3% for the Subtotal domain. In multivariate analysis, preoperative SRS-22r Function (odds ratio [OR] = 0.204, 95% confidence interval [CI] 0.105-0.396) increased the likelihood of achieving MCID for SRS-22r Function. Preoperative SRS-22r Subtotal (OR = 0.211, 95% CI, 0.107-0.413), preoperative pelvic tilt (OR = 1.072, 95% CI, 1.012-1.136), preoperative pelvic incidence minus lumbar lordosis (OR = 0.965, 95% CI, 0.934-0.997), and postoperative sagittal vertical axis (OR = 0.985, 95% CI, 0.974-0.995) affected the likelihood of achieving MCID for the SRS-22r Subtotal.ConclusionPatients with poor preoperative health-related quality of life were more likely to achieve improvement in SRS-22r parameters after extensive corrective fusion surgery for ASD. Achieving postoperative sagittal alignment increased the likelihood of achieving MCID for the SRS-22r Subtotal domain.Level of Evidence: 3.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

30 keywords...

hide…