• Jin-Sung Park, Chong-Suh Lee, Byeong-Jik Kang, Aditya Raj, Tae-Soo Shin, and Se-Jun Park.
• Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul , South Korea.
• Neurosurgery. 2023 Sep 1; 93 (3): 654661654-661.

BackgroundAlthough several studies were performed to measure stiffness-related functional disability (SRFD) after long segmental fusion for adult spinal deformity, the evaluation of SRFD was done at a single point in time. We do not know whether the disability will stay the same, worsen, or improve over time.ObjectiveTo evaluate the time-dependent changes of SRFD and any factors affecting these changes.MethodsPatients who had ≥4-segment fusion with the sacrum were reviewed retrospectively. Specific Functional Disability Index (SFDI), consisting of a 12-item tool with 4 categories (sitting on the floor, sanitation activities, lower body activities, and moving activities), was used to assess the severity of SRFD. The SFDI taken at 3 months, 1 year, and 2 years postoperatively and at the last follow-up were used for evaluating the changes in SRFD. The presumed factors affecting these changes were analyzed.ResultsThis study included 116 patients. Total SFDI scores significantly improved from 3-month to the last follow-up. Among the 4-category of SFDI, sitting on the floor showed the highest scores followed by lower body activities, sanitation activities, and moving activities at all time points. All categories except for sitting on the floor showed significant improvement from 3 months until the last follow-up. This improvement was most pronounced between 3 months and 1 year. American Society of Anaesthesiologists grade was identified as the only factor affecting time-dependent changes.ConclusionSRFD was highest at 3 months, but it improved over time except for sitting on the floor. The improvement was observed greatest between 3 months and 1 year. Patients with less American Society of Anaesthesiologists grade experienced more improvement in SRFD.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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