194. Outcomes of surgical treatment for 138 patients with severe sagittal deformity at a minimum two-year follow-up

Abstract

BACKGROUND CONTEXT The operative treatment of adult spinal deformity (ASD) can be very technically challenging with high complication rates. Despite these challenges it is well established that patients ultimately benefit from such treatment. However the surgical outcomes for patients with severe sagittal deformity have not been reported. PURPOSE To investigate whether patients with severe sagittal deformity have favorable outcomes following surgical correction. STUDY DESIGN/SETTING Retrospective review of a prospective, multicenter adult spinal deformity (ASD) database. PATIENT SAMPLE Inclusion criteria: operative patients with age ≥18, SVA ≥15cm, PI-LL ≥30°, and/or lumbar kyphosis ≥5° with minimum 2-yr follow-up. OUTCOME MEASURES Health-related quality of life (HRQOL) scores included: Oswestry Disability Index (ODI), Short Form-36 (SF36), Scoliosis Research Society (SRS22), back/leg pain numerical rating scale (NRS) and minimum clinically important difference (MCID)/substantial clinical benefit (SCB) for pts eligible to meet them. Radiographic values included: max coronal cobb angle, coronal C7 plumb line, pelvic tilt (PT), mismatch between pelvic incidence and lumbar lordosis (PI-LL), thoracic kyphosis (TK), C7 sagittal vertical axis (SVA). Demographic, frailty, surgical, and complications data were also collected. METHODS Comparisons between 2-yr postop and baseline HRQOL/radiographic data were made. P RESULTS A total of 138 pts were included (54.3% Female, ave age 63.3±11.5yrs). Ave baseline frailty score was 4.1±1.4 indicating the pt to befrail. Ave OR time 386.2±136.5min, EBL 1829.8±1474.6cc. 71 (51.4%) of the pts had a prior fusion; 89.9% posterior fusion only, 9.4% combined anterior-posterior approach. Mean number posterior levels fused 11.5±4.1. 44.9% had a 3-column osteotomy and 68.8% had interbody fusion. All 2-yr postop radiographic parameters were significantly improved compared to baseline (p 0.05). All 2-yr HRQOL measures were significantly improved compared to baseline (p CONCLUSIONS Pts with severe sagittal malalignment benefit from surgical correction at 2-yrs postop both radiographically and clinically despite having a high complication rate. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.