PMID- 34036834 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230519 IS - 2192-5682 (Print) IS - 2192-5690 (Electronic) IS - 2192-5682 (Linking) VI - 13 IP - 4 DP - 2023 May TI - Do Adult Spinal Deformity Patients Undergoing Surgery Continue to Improve From 1-Year to 2-Years Postoperative? PG - 1080-1088 LID - 10.1177/21925682211019352 [doi] AB - OBJECTIVE: Evaluate clinical improvement as measured by patient-reported outcomes (PROs) during the 1 to 2-year interval. STUDY DESIGN: Retrospective Cohort. METHODS: A single-institution registry of ASD patients undergoing surgery was queried for patients with >/=6 level fusions. Demographics and radiographic variables were collected. PROs collected were the ODI and SRS-22r scores at: preoperative, 1-year and 2-years. Outcome measures of clinical improvement during the 1-2 year time interval were: 1) group medians, 2) percent minimum clinically important difference (MCID), and 3) percent minimal symptom scale (MSS)(ODI < 20 or SRS-pain + function >8). Wilcoxon rank-sum tests, chi-squared tests, Kruskal-Wallis tests, and logistic regression were performed. RESULTS: 157 patients undergoing ASD surgery with minimum of 1-year follow-up were included. Mean age was 53.2 and mean instrumented levels was 13.1. Preoperative alignment was: Neutral Alignment (NA) 49%, Coronal Malalignment (CM) 17%, Sagittal Malalignment (SM 17%), and Combined Coronal/Sagittal Malalignment (CCSM) 18%. Preoperative to 1-year, and preoperative to 2-years, all ODI/SRS-22r significantly improved (P < .001). In all patients, the only significant improvement in PROs between 1-and 2-year postoperative were those reaching ODI MCID (69% 1-year vs. 84% 2-years; P < .001). Subgroup analysis: >/=55 years had an improved median ODI (18 vs. 8; P = .047) and an improved percent achieving ODI MCID (73% vs. 84%, P = .048). CCSM patients experienced significant improvement in SRS-appearance score (75% vs. 100%; P = .050), along with those with severe preoperative SM >7.5 cm (73% vs. 100%; P = .032). CONCLUSIONS: Most ASD patients experience the majority of PRO improvement by 1-year postoperative. However, subsets of patients that may continue to improve up to 2-years postoperative include patients >/=55 years, combined coronal/sagittal malalignment, and those with severe sagittal malalignment >/=7.5 cm. FAU - Zuckerman, Scott L AU - Zuckerman SL AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 AD - Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. RINGGOLD: 12328 FAU - Lai, Christopher S AU - Lai CS AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Shen, Yong AU - Shen Y AUID- ORCID: 0000-0002-4866-838X AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Cerpa, Meghan AU - Cerpa M AUID- ORCID: 0000-0002-5931-7067 AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Lee, Nathan J AU - Lee NJ AUID- ORCID: 0000-0001-9572-5968 AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Kerolus, Mena G AU - Kerolus MG AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Ha, Alex S AU - Ha AS AUID- ORCID: 0000-0001-8057-9996 AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Buchanan, Ian A AU - Buchanan IA AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Devin, Clinton J AU - Devin CJ AD - Steamboat Orthopaedic and Spine Institute, Steamboat Springs, CO, USA. FAU - Lehman, Ronald A AU - Lehman RA AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 FAU - Lenke, Lawrence G AU - Lenke LG AD - Department of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, NY, USA. RINGGOLD: 21611 LA - eng PT - Journal Article DEP - 20210526 PL - England TA - Global Spine J JT - Global spine journal JID - 101596156 PMC - PMC10189321 OTO - NOTNLM OT - adult spine deformity OT - minimum clinically important difference OT - patient reported outcomes OT - postoperative outcomes OT - spine surgery COIS- The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2021/05/27 06:00 MHDA- 2021/05/27 06:01 PMCR- 2021/05/26 CRDT- 2021/05/26 08:43 PHST- 2021/05/27 06:01 [medline] PHST- 2021/05/27 06:00 [pubmed] PHST- 2021/05/26 08:43 [entrez] PHST- 2021/05/26 00:00 [pmc-release] AID - 10.1177_21925682211019352 [pii] AID - 10.1177/21925682211019352 [doi] PST - ppublish SO - Global Spine J. 2023 May;13(4):1080-1088. doi: 10.1177/21925682211019352. Epub 2021 May 26.