Abstract
BACKGROUND CONTEXT Despite reports showing positive long-term functional outcomes following adult spinal deformity (ASD) corrective surgery, it is still unclear which factors may impact the durability of these outcomes. PURPOSE Assess durability of functional gains following ASD-corrective surgery, and determine predictors for postoperative loss of functionality. STUDY DESIGN/SETTING Retrospective review of prospective, multi-center ASD patient database. PATIENT SAMPLE A total of 166 surgical ASD patients (57±15 year, 75%F, BMI: 26.7±6.1). OUTCOME MEASURES Oswestry Disability Index (ODI), modified frailty index (mFI). METHODS Included: surgical ASD patients (scoliosis≥20°, SVA≥5 cm, PT≥25° and/or TK>60°)≥18years with 3-year ODI follow-up, and 1-year postop (1 year) ODI scores reaching substantial clinical benefit threshold(SCB, RESULTS All 166 included surgical ASD patients(11±4 lvls; 68% posterior approach, 2% anterior, 31% combined; 64% of cases involved osteotomy, 55% decompression), showed baseline (BL) to 1 year functional improvement (mean ODI: 35.3±16.5 to 13.6±9.2, P 2 vs. 28, P=0.010), and lower rates of reoperation past 1Y(9% vs. 23%, P=.011), BL osteoporosis (9% vs. 23%, P=.019), cancer(4% vs. 19%, P=.002), heart disease (6% vs. 21%, P=.004), hypertension (28% vs. 54%, P=.001), and lung disease (1% vs. 6%, P=.040). Multivariate analysis showed lung disease (HR:4.8 [1.4-16.4]), 1 year frailty(HR:1.4 [1.1-1.9]), and posterior approach (HR:2.6 [1.2-5.8]) as associated with shorter time to functional decline. CONCLUSIONS A total of 71% of surgical ASD patients maintained satisfactory functional outcomes by 3-year postoperative. Of those who failed to sustain satisfactory functionality, the largest functional decline was observed at the 3-year postop interval. Patient frailty, preoperative comorbidity burden, and surgical approach all affected the durability of functional gains following ASD-corrective surgery. Evidence of functional deterioration in patients with these factors should be taken into account to improve patient counseling. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call