Journal Article

Patient-Reported Outcomes After Complex Adult Spinal Deformity Surgery: 5-Year Results of the Scoli-Risk-1 Study

Frank J. Schwab, Yong Qiu, Kenneth M.C. Cheung, Justin S. Smith, Christopher I. Shaffrey, Scott L. Zuckerman, Yukihiro Matsuyama, Michael G. Fehlings, Ferran Pellisé, Michael P. Kelly, Oheneba Boachie-Adjei, Christopher P Ames, Leah Y. Carreon, AO Spine Knowledge Forum Deformity, Khaled M Kabeaish, Meghan Cerpa, Stephen J. Lewis, Lawrence G. Lenke, Mark B. Dekutoski

2022

Overview

Study Design: Prospective cohort. Objective: To prospectively evaluate PROs up to 5-years after complex ASD surgery. Methods: The Scoli-RISK-1 study enrolled 272 ASD patients undergoing surgery from 15 centers. Inclusion criteria was Cobb angle of >80°, corrective osteotomy for congenital or revision deformity, and/or 3-column osteotomy. The following PROs were measured prospectively at intervals up to 5-years postoperative: ODI, SF36-PCS/MCS, SRS-22, NRS back/leg. Among patients with 5-year follow-up, comparisons were made from both baseline and 2-years postoperative to 5-years postoperative. PROs were analyzed using mixed models for repeated measures. Results: Seventy-seven patients (28.3%) had 5-year follow-up data. Comparing baseline to 5-year data among these 77 patients, significant improvement was seen in all PROs: ODI (45.2 vs. 29.3, P < 0.001), SF36-PCS (31.5 vs. 38.8, P < 0.001), SF36-MCS (44.9 vs. 49.1, P = 0.009), SRS-22-total (2.78 vs. 3.61, P < 0.001), NRS-back pain (5.70 vs. 2.95, P < 0.001) and NRS leg pain (3.64 vs. 2.62, P = 0.017). In the 2 to 5-year follow-up period, no significant changes were seen in any PROs. The percentage of patients achieving MCID from baseline to 5-years were: ODI (62.0%) and the SRS-22r domains of function (70.4%), pain (63.0%), mental health (37.5%), self-image (60.3%), and total (60.3%). Surprisingly, mean values (P > 0.05) and proportion achieving MCID did not differ significantly in patients with major surgery-related complications compared to those without. Conclusions: After complex ASD surgery, significant improvement in PROs were seen at 5-years postoperative in ODI, SF36-PCS/MCS, SRS-22r, and NRS-back/leg pain. No significant changes in PROs occurred during the 2 to 5-year postoperative period. Those with major surgery-related complications had similar PROs and proportion of patients achieving MCID as those without these complications.

• Publisher: SAGE Publications,Sage Publications Ltd
• Subject: adult idiopathic scoliosis / adult spinal deformity / afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias [ENFERMEDADES] / AO Spine Knowledge Forum Deformity and SRS Scoli-RISK-1 Study Group / Biomedical and Clinical Sciences / Brain Disorders / Cirurgia - Complicacions / Clinical Research / Clinical Sciences / Columna vertebral - Malformacions - Cirurgia / deformity / enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral [ENFERMEDADES] / Good Health and Well Being / Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires::Health Care Surveys::Patient Reported Outcome Measures [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] / Musculoskeletal Diseases::Bone Diseases::Spinal Diseases [DISEASES] / Original / Original Articles / Other subheadings::Other subheadings::/surgery [Other subheadings] / Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] / Pacients - Satisfacció / Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications [DISEASES] / patient reported outcomes / spinal deformity surgery / Surgery / técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios::encuestas sobre atención a la salud::medidas de resultados percibidos por los pacientes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]