• Ravi Verma, Renaud Lafage, Justin Scheer, Justin Smith, Peter Passias, Richard Hostin, Christopher Ames, Gregory Mundis, Douglas Burton, Han Jo Kim, Shay Bess, Eric Klineberg, Frank Schwab, Virginie Lafage, and International Spine Study Group.
• New York Medical College, Department of Orthopaedic Surgery, Valhalla, NY.
• Spine. 2019 Feb 15; 44 (4): 263-269.

Study DesignA retrospective review of a prospective, multicenter adult spinal deformity (ASD) database.ObjectiveOur objective was to quantify the change in disability reported for patients with radiculopathy as compared with patients with back pain only following ASD realignment surgery.Summary Of Background DataStudies utilizing patient-reported outcomes (PROs) have shown that ASD patients suffer from significant pain and disability. Although surgical correction has been effective at improving back and leg pain, no studies have investigated the impact of radiculopathy on pain and disability in ASD patients.MethodsInclusion criteria were age ≥ 18 years and presence of spinal deformity as defined by coronal Cobb angle ≥ 20°, sagittal vertical axis (SVA) ≥ 5 cm, pelvic tilt (PT) angle ≥ 25°, or thoracic kyphosis (TK) angle ≥ 60°. Demographics and PRO were collected. Patients with radiculopathy were propensity matched with patients with back pain. Preoperative, postoperative, and 2-year follow-up radiographic parameters and PRO were analyzed.ResultsThree hundred twenty-four patients met inclusion criteria, and following propensity matching, 90 patients were placed into the radiculopathy and back pain groups. These groups showed no difference in demographic or radiographic parameters. The groups were similar in PRO, with a difference in leg pain as per design. At baseline, leg pain patients had higher disability [Oswestry Disability Index (ODI) and Scoliosis Research Society (SRS)]. Surgical strategies between the two groups showed no differences. Postoperative radiographic parameters showed no difference. Despite a significantly greater decrease in numerical rating scale (NRS) Leg for the leg pain group, postoperatively, these patients remained more disabled than the nonleg group in terms of NRS (back and leg), ODI, and most of the SRS domains.ConclusionASD patients with radiculopathy exhibit increased pain and disability when compared with patients without leg pain. This increased pain and disability persists after surgical correction in these patients.Level Of Evidence3.

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