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Review Meta Analysis
Impact of pedicle subtraction osteotomy on health-related quality of life (HRQOL) measures in patients undergoing surgery for adult spinal deformity: a systematic review and meta-analysis.
- Ahmad M Tarawneh, Muralidharan Venkatesan, Dritan Pasku, Jagdeep Singh, and Nasir A Quraishi.
- Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. neurostarawneh@hotmail.com.
- Eur Spine J. 2020 Dec 1; 29 (12): 2953-2959.
Study DesignSystematic review and meta-analysis.BackgroundThree-column osteotomies (3-CO) have gained popularity in the last decade as part of the armamentarium for the surgical correction of sagittal imbalance in patients with adult spinal deformity (ASD). Three-column osteotomies in the form of pedicle subtraction osteotomy (PSO) may be necessary to achieve adequate correction for severe and rigid spinal deformity. Studies reporting improvement in health-related quality of life (HRQOL) with validated outcome measures after PSO surgery are sparse and currently consist of small series.ObjectiveEvaluate the improvement in HRQOL measures following PSO for adult spinal deformity.MethodsTwo independent reviewers conducted a systematic review of the English literature between period 1996 and 2019 for articles reporting outcome of PSO in patients with ASD according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Inclusion criteria were studies consisting of patient-reported outcome Oswestry Disability Index (ODI) and Scoliosis Research Society 22 or 24 (SRS) outcomes after PSO surgery for adult spine deformity patients (18 years or older) with a minimum follow-up of 1 year.ResultsEight studies with 431 PSOs were included in the meta-analysis. The results showed a statistically significant improvement in ODI in PSO (P < 0.0001), and the mean clinically important difference was achieved with both ODI (50.46 (45.5-55.4) preoperatively to 32.78 (29.7-39) postoperatively) and SRS (2.49 (2.38-2.7) preoperatively to 3.26 (2.8-4.1) postoperatively) scores.ConclusionThis meta-analysis did find improvements in the health-related quality of life in patients undergoing PSO surgery for adult spinal deformity.
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