PMID- 33231944
OWN - NLM
STAT- MEDLINE
DCOM- 20210104
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 45
IP  - 24
DP  - 2020 Dec 15
TI  - Risk Factors Associated With Failure to Reach Minimal Clinically Important 
      Difference After Correction Surgery in Patients With Degenerative Lumbar 
      Scoliosis.
PG  - E1669-E1676
LID - 10.1097/BRS.0000000000003713 [doi]
AB  - STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to 
      evaluate the factors affecting health-related quality of life (HRQOL) after 
      surgery in patients with degenerative lumbar scoliosis (DLS) by minimum 
      clinically important difference (MCID). SUMMARY OF BACKGROUND DATA: MCID has been 
      introduced in the adult spinal deformity to quantify the absolute minimum change 
      that can be considered a success. There are limited data available to identify 
      factors affecting reaching MCID after DLS surgery. METHODS: This study reviewed a 
      cohort of 123 DLS patients after correction surgery and with a minimum 2-year 
      follow-up (FU). Inclusion criteria included age >/=40 and minimum five vertebrae 
      fused and the availability of Scoliosis Research Society (SRS)-22 scores and 
      radiographic data at baseline (BL) and FU. Using a multivariate analysis, two 
      groups were compared to identify possible risk factors: those who reached MCID in 
      the all four SRS domains (N = 65) at the last FU and those who missed MCID 
      (N = 58). RESULTS: At baseline, patients differed significantly from matched 
      normative data in all SRS-22 domains. The baseline HRQOL was comparable in 
      reached MCID and missed MCID group patients (P > 0.05). The HRQOL scores at FU 
      were significantly higher than those at baseline. Of 123 included patients, 77.2% 
      (N = 95), 72.4% (N = 89), 76.4% (N = 94), and 89.4% (N = 110) reached MCID in SRS 
      pain, activity, appearance, and mental domain, respectively. Pelvic incidence 
      (PI) >55 degrees , lumbar lordosis (LL) loss >4.65 degrees , coronal imbalance at FU, sagittal 
      vertical axis (SVA) at FU >80 mm, and presence of proximal junctional kyphosis 
      (PJK) and distal junctional problem (DJP) had negative effects on the recovery 
      process. CONCLUSION: Factors affecting reaching MCID after surgery for DLS were 
      higher PI, LL loss, coronal imbalance, severe sagittal imbalance, and the 
      occurrence of PJK and DJP. LEVEL OF EVIDENCE: 4.
FAU - Yuan, Lei
AU  - Yuan L
AD  - Department of orthopedics, Peking University Third Hospital, No 49. North Garden 
      Street, Beijing, China.
FAU - Zeng, Yan
AU  - Zeng Y
FAU - Chen, Zhongqiang
AU  - Chen Z
FAU - Li, Weishi
AU  - Li W
FAU - Zhang, Xinling
AU  - Zhang X
FAU - Ni, Jiajun
AU  - Ni J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Kyphosis/surgery
MH  - Lordosis/surgery
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Scoliosis/*surgery
MH  - Young Adult
EDAT- 2020/11/25 06:00
MHDA- 2021/01/05 06:00
CRDT- 2020/11/24 13:52
PHST- 2020/11/24 13:52 [entrez]
PHST- 2020/11/25 06:00 [pubmed]
PHST- 2021/01/05 06:00 [medline]
AID - 00007632-202012150-00011 [pii]
AID - 10.1097/BRS.0000000000003713 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2020 Dec 15;45(24):E1669-E1676. doi: 
      10.1097/BRS.0000000000003713.