Abstract
Purpose: Identifying perioperative factors that may influence the outcomes of long spine fusion for the treatment of adult deformity is key for tailored surgical planning and targeted informed consent. The aim of this study was to analyze the association between demographic or perioperative factors and clinical outcomes 2 years after long spine fusion for the treatment of adult deformity. Methods: This study is a multivariate analysis of retrospectively collected data. All patients who underwent long fusion of the lumbar spine for adult spinal deformity (January 2016–June 2019) were included. The outcomes of interest were the Oswestry disability index (ODI), visual analogic scale (VAS) preoperatively and at 1 and 2 years’ follow up, age, body mass index, American Society of Anaesthesiologists (ASA) score, upper and lowest instrumented vertebrae (UIV and LIV, respectively), length of surgery, estimated blood loss, and length of hospital stay. Results: Data from 192 patients were available. The ODI at 2 years correlated weakly to moderately with age (r = 0.4), BMI (r = 0.2), ASA (r = 0.3), and LIV (r = 0.2), and strongly with preoperative ODI (r = 0.6). The leg VAS at 2 years moderately correlated with age (r = 0.3) and BMI (r = 0.3). Conclusion: ODI and VAS at 2 years’ follow-up had no to little association to preoperative age, health status, LIV, or other peroperative data, but showed a strong correlation with preoperative ODI and pain level.
Highlights
The social burden caused by low back pain (LBP) is relevant, having a first-ever episode incidence of 15% and an 80% recurrence rate within a year [1]
This percentage increases in patients affected by adult spine deformity [2] and various studies showed that this condition has a negative impact on the patients’ quality of life [3,4]
Analyzing the correlation of Oswestry disability index (ODI), visual analogic scale (VAS), or CB with the extent of the instrumentation, we found that the level of the UIV did not affect any of the outcomes of interest
Summary
The social burden caused by low back pain (LBP) is relevant, having a first-ever episode incidence of 15% and an 80% recurrence rate within a year [1]. This percentage increases in patients affected by adult spine deformity [2] and various studies showed that this condition has a negative impact on the patients’ quality of life [3,4]. Surgical deformity correction involves complex procedures; given the advances in surgical and anesthesiological techniques, it is possible to perform surgery in patients at an older age and with more comorbidities [5–8]. Disability and pain levels play a decisive role in the assessment of a patient and in the decision-making process [9]. Patient-reported outcome measures (PROMs) are used to obtain a more complete overview of a patient’s status, as they allow to match objective informations such as radiographic findings with subjective data regarding different aspects of the patient’s with regard to jurisdictional claims in published maps and institutional affiliations
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