296. Residual coronal malalignment results in less improvement in pain and disability after ASD surgery

Abstract

BACKGROUND CONTEXT Prior literature has demonstrated that correction of sagittal plane deformity in adult patients has resulted in improvements in health-related quality of life (HRQOL) outcomes. In the absence of sagittal plane pathology, the effects of coronal malalignment under-correction in patients with spinal deformity have not been fully investigated. PURPOSE To evaluate the impact of coronal malalignment correction on HRQOL outcomes in adult spinal deformity. STUDY DESIGN/SETTING Retrospective review of a multicenter database. PATIENT SAMPLE A total of 522 ASD patients had preoperative coronal malalignment greater than 40 mm. We excluded anyone who had SVA greater than 50 mm in order to control for patients without severe sagittal deformities. OUTCOME MEASURES Our outcome measures included Oswestry Disability Index (ODI), SF-36 Physical Component Summary (PCS), and several other SF-36 and SRS-22r health domains scores. METHODS Using a prospective, multicenter database, we identified 1560 surgical patients. Of these, 522 patients had preoperative coronal malalignment greater than 40 mm. We excluded anyone who had SVA greater than 50 mm in order to control for patients who only had coronal plane deformity. We only included patients undergoing primary surgery. We then compared 2-year post HRQOL outcomes in patients that had their coronal malalignment corrected (CVA RESULTS Mean age of patients was 54 ± 15 years, 91% females. 79 patients were identified with only a coronal plane deformity undergoing a primary ASD surgery. Of these, 38 (48%) were under-corrected and 41 (52%) had their coronal alignment corrected to CONCLUSIONS Patients with coronal malalignment and little sagittal plane deformity experience worse improvement in pain and disability, with under-correction of their coronal plane deformity. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.