PMID- 32005027
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240517
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 32
IP  - 6
DP  - 2020 Jan 31
TI  - Reaching minimal clinically important difference in adult spinal deformity 
      surgery: a comparison of patients from North America and Japan.
PG  - 859-864
LID - 10.3171/2019.12.SPINE19593 [doi]
AB  - OBJECTIVE: The Scoliosis Research Society-22r questionnaire (SRS-22r) has been 
      shown to be reliable, valid, and responsive to change in patients with adult 
      spinal deformity (ASD) undergoing surgery. The minimal clinically important 
      difference (MCID) is the smallest difference in a health-related quality of life 
      score that is considered to be worthwhile or clinically important to the 
      individual. The authors hypothesized that the proportion of patients with ASD 
      achieving an MCID in the SRS-22r score would be different between two culturally 
      different cohorts. The purpose of this study was to compare the proportion of 
      patients with ASD achieving MCID for the SRS-22r domains in North American (NA) 
      and Japanese cohorts. METHODS: A total of 137 patients from North America (123 
      women, mean age 60.0 years) and 60 patients from Japan (56 women, mean age 65.5 
      years) with at least 2 years of follow-up after corrective spine surgery for ASD 
      were included. Except for self-image, published Japanese MCID values of SRS-22r 
      for ASD were higher (function = 0.90, pain = 0.85, self-image = 1.05, subtotal = 
      1.05) than the published NA MCID values (function = 0.60, pain = 0.40, self-image 
      = 1.23, subtotal = 0.43). RESULTS: There was a statistically significant 
      improvement in all SRS-22r domain scores at 2 years compared to baseline in both 
      cohorts. Except for mental health (NA = 0.32, Japanese = 0.72, p = 0.005), the 
      mean improvement from baseline to 2 years was similar between the NA and Japanese 
      cohorts. The proportion of patients achieving MCID was higher in North America 
      for function (NA = 51%, Japanese = 30%, p = 0.006), pain (NA = 80%, Japanese = 
      47%, p < 0.001), and subtotal (NA = 72%, Japanese = 35%, p < 0.001), while there 
      was no significant difference for self-image (NA = 53%, Japanese = 58%, p = 
      0.454). CONCLUSIONS: Despite similar improvements in SRS-22r domain scores from 
      baseline to 2 years postoperatively, the proportion of patients reaching SRS-22r 
      MCID for function, pain, and subtotal after ASD surgery was higher in the NA 
      cohort than in the Japanese cohort. This may imply that patients in North America 
      and Japan may value observed changes in clinical status differently.
FAU - Arima, Hideyuki
AU  - Arima H
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
AD  - 2Department of Orthopedic Surgery, University of Louisville School of Medicine, 
      Louisville, Kentucky.
AD  - 3Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 
      Hamamatsu, Shizuoka, Japan.
FAU - Glassman, Steven D
AU  - Glassman SD
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
AD  - 2Department of Orthopedic Surgery, University of Louisville School of Medicine, 
      Louisville, Kentucky.
FAU - Bridwell, Keith
AU  - Bridwell K
AD  - 4Washington University in St. Louis, Missouri.
FAU - Yamato, Yu
AU  - Yamato Y
AD  - 3Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 
      Hamamatsu, Shizuoka, Japan.
FAU - Yagi, Mitsuru
AU  - Yagi M
AD  - 5Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, 
      Japan; and.
FAU - Watanabe, Kota
AU  - Watanabe K
AD  - 5Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, 
      Japan; and.
FAU - Matsumoto, Morio
AU  - Matsumoto M
AD  - 5Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, 
      Japan; and.
FAU - Inami, Satoshi
AU  - Inami S
AD  - 6Department of Orthopaedic Surgery, Dokkyo Medical University, Tochigi, Japan.
FAU - Taneichi, Hiroshi
AU  - Taneichi H
AD  - 6Department of Orthopaedic Surgery, Dokkyo Medical University, Tochigi, Japan.
FAU - Matsuyama, Yukihiro
AU  - Matsuyama Y
AD  - 3Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 
      Hamamatsu, Shizuoka, Japan.
FAU - Carreon, Leah Y
AU  - Carreon LY
AD  - 1Norton Leatherman Spine Center, Louisville, Kentucky.
AD  - 2Department of Orthopedic Surgery, University of Louisville School of Medicine, 
      Louisville, Kentucky.
LA  - eng
PT  - Journal Article
DEP - 20200131
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - Scoliosis Research Society-22r
OT  - adult scoliosis
OT  - adult spinal deformity
OT  - cultural difference
OT  - minimum clinically important difference
EDAT- 2020/02/01 06:00
MHDA- 2020/02/01 06:01
CRDT- 2020/02/01 06:00
PHST- 2019/05/26 00:00 [received]
PHST- 2019/12/02 00:00 [accepted]
PHST- 2020/02/01 06:01 [medline]
PHST- 2020/02/01 06:00 [pubmed]
PHST- 2020/02/01 06:00 [entrez]
AID - 2019.12.SPINE19593 [pii]
AID - 10.3171/2019.12.SPINE19593 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2020 Jan 31;32(6):859-864. doi: 10.3171/2019.12.SPINE19593.