PMID- 33394978 OWN - NLM STAT- MEDLINE DCOM- 20210503 LR - 20210503 IS - 1528-1159 (Electronic) IS - 0362-2436 (Linking) VI - 46 IP - 6 DP - 2021 Mar 15 TI - Factors Associated with Improved Quality of Life Outcomes in Patients Undergoing Surgery for Adult Spinal Deformity. PG - E384-E391 LID - 10.1097/BRS.0000000000003908 [doi] AB - STUDY DESIGN: Retrospective longitudinal cohort study. OBJECTIVE: This study aimed to elucidate factors affecting the likelihood of achieving minimum clinically important difference (MCID) to patient-reported outcomes defined by the Scoliosis Research Society-22r (SRS-22r) among patients with adult spinal deformity (ASD) who underwent extensive corrective fusion surgery from the thoracic spine to the pelvis. SUMMARY OF BACKGROUND DATA: Achieving MCID for SRS-22r parameters was a measure of surgical efficacy. Patient characteristics and surgical and radiographic factors that affect the likelihood of achieving MCID for SRS-22r parameters are unknown. METHODS: Data from patients with ASD who underwent extensive corrective fusion surgery from the thoracic spine to the pelvis during 2010 to 2016 were retrospectively reviewed. Data from a total of 167 patients with >/=2 years of follow-up were included. Multivariate analysis was used to investigate factors associated with the likelihood of achieving MCID for each of the SRS-22r domains (Function, Pain, Subtotal) 2 years after surgery. The following MCID values were used: 0.90 for Function, 0.85 for Pain, and 1.05 for the Subtotal. RESULTS: MCID achievement rate was 36.5% for Function, 46.1% for Pain, and 44.3% for the Subtotal domain. In multivariate analysis, preoperative SRS-22r Function (odds ratio [OR] = 0.204, 95% confidence interval [CI] 0.105-0.396) increased the likelihood of achieving MCID for SRS-22r Function. Preoperative SRS-22r Subtotal (OR = 0.211, 95% CI, 0.107-0.413), preoperative pelvic tilt (OR = 1.072, 95% CI, 1.012-1.136), preoperative pelvic incidence minus lumbar lordosis (OR = 0.965, 95% CI, 0.934-0.997), and postoperative sagittal vertical axis (OR = 0.985, 95% CI, 0.974-0.995) affected the likelihood of achieving MCID for the SRS-22r Subtotal. CONCLUSION: Patients with poor preoperative health-related quality of life were more likely to achieve improvement in SRS-22r parameters after extensive corrective fusion surgery for ASD. Achieving postoperative sagittal alignment increased the likelihood of achieving MCID for the SRS-22r Subtotal domain.Level of Evidence: 3. CI - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved. FAU - Arima, Hideyuki AU - Arima H AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Hasegawa, Tomohiko AU - Hasegawa T AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Yamato, Yu AU - Yamato Y AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. AD - Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Togawa, Daisuke AU - Togawa D AD - Department of Orthopedic Surgery, Kinki University Nara Hospital, Ikoma-city, Nara, Japan. FAU - Yoshida, Go AU - Yoshida G AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Yasuda, Tatsuya AU - Yasuda T AD - Department of Orthopedic Surgery, Iwata city hospital, Iwata-city, Shizuoka, Japan. FAU - Banno, Tomohiro AU - Banno T AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Oe, Shin AU - Oe S AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. AD - Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Mihara, Yuki AU - Mihara Y AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Ushirozako, Hiroki AU - Ushirozako H AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Yamada, Tomohiro AU - Yamada T AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Watanabe, Yuh AU - Watanabe Y AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Ide, Koichiro AU - Ide K AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Nakai, Keiichi AU - Nakai K AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. FAU - Matsuyama, Yukihiro AU - Matsuyama Y AD - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan. LA - eng PT - Journal Article PL - United States TA - Spine (Phila Pa 1976) JT - Spine JID - 7610646 SB - IM MH - Adult MH - Aged MH - Cohort Studies MH - Female MH - Follow-Up Studies MH - Humans MH - Longitudinal Studies MH - Lordosis/diagnostic imaging/psychology/*surgery MH - Lumbar Vertebrae/diagnostic imaging/*surgery MH - Male MH - Middle Aged MH - *Quality of Life/psychology MH - Retrospective Studies MH - Scoliosis/diagnostic imaging/psychology/*surgery MH - Spinal Fusion/psychology/*trends MH - Thoracic Vertebrae/diagnostic imaging/*surgery MH - Treatment Outcome EDAT- 2021/01/05 06:00 MHDA- 2021/05/04 06:00 CRDT- 2021/01/04 16:09 PHST- 2021/01/05 06:00 [pubmed] PHST- 2021/05/04 06:00 [medline] PHST- 2021/01/04 16:09 [entrez] AID - 00007632-202103150-00009 [pii] AID - 10.1097/BRS.0000000000003908 [doi] PST - ppublish SO - Spine (Phila Pa 1976). 2021 Mar 15;46(6):E384-E391. doi: 10.1097/BRS.0000000000003908.