PMID- 34435989 OWN - NLM STAT- MEDLINE DCOM- 20210831 LR - 20210831 IS - 1528-1159 (Electronic) IS - 0362-2436 (Linking) VI - 46 IP - 18 DP - 2021 Sep 15 TI - Does Matching Roussouly Spinal Shape and Improvement in SRS-Schwab Modifier Contribute to Improved Patient-reported Outcomes? PG - 1258-1263 LID - 10.1097/BRS.0000000000003999 [doi] AB - STUDY DESIGN: Retrospective review. OBJECTIVE: The aim of this study was to evaluate outcomes of matching Roussouly and improving in Schwab modifier following adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: The Roussouly Classification system of sagittal spinal shape and the SRS-Schwab classification system have become important indicators of spine deformity. No previous studies have examined the outcomes of matching both Roussouly type and improving in Schwab modifiers postoperatively. METHODS: Surgical ASD patients with available baseline (BL) and 1 year (1Y) radiographic data were isolated in the single-center spine database. Patients were classified by their "theoretical" and "current" Roussouly types as previously published. Patients were considered a "Match" if their theoretical and current Roussouly types were the same, or a "Mismatch" if the types differed. Patients were noted as improved if they were Roussouly "Mismatch" preoperatively, and "Match" at 1Y postop. Schwab modifiers at BL were categorized as follows: no deformity (0), moderate deformity (+), and severe deformity (++) for PT, SVA, and PI-LL. Improvement in SRS-Schwab was defined as a decrease in any modifier severity at 1Y. RESULTS: 103 operative ASD patients (61.8 years, 63.1% female, 30 kg/m2) were included. At baseline, breakdown of "current" Roussouly type was: 28% Type 1, 25.3% Type 2, 32.0% Type 3, 14.7% Type 4. 65.3% of patients were classified as Roussouly "Mismatch" at BL. Breakdown of BL Schwab modifier severity: PT (+: 41.7%, ++: 49.5%), SVA (+: 20.3%, ++: 50%), PI-LL (+: 25.2%, ++: 46.6%). At 1 year postop, 19.2% of patients had Roussouly "Match". Analysis of Schwab modifiers showed that 12.6% improved in SVA, 42.7% in PI-LL, and 45.6% in PT. Count of patients who both had a Roussouly type "Match" at 1Y and improved in Schwab modifier severity: nine PT (8.7%), eight PI-LL (7.8%), and two SVA (1.9%). There were two patients (1.9%) who met their Roussouly type and improved in all three Schwab. 1Y matched Roussouly patients improved more in health-related quality of life scores (minimal clinically important difference [MCID] for Oswestry Disability Index [ODI], EuroQol-5D-3L [EQ5D], Visual Analogue Score Leg/Back Pain), compared to mismatched, but was not significant (P > 0.05). Match Roussouly and improvement in PT Schwab met MCID for EQ5D more (P = 0.050). Matched Roussouly and improvement in SVA Schwab met MCID for ODI more (P = 0.024). CONCLUSION: Patients who both matched Roussouly sagittal spinal type and improved in SRS-Schwab modifiers had superior patient-reported outcomes. Utilizing both classification systems in surgical decision-making can optimize postop outcomes.Level of Evidence: 3. CI - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved. FAU - Passias, Peter G AU - Passias PG AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Pierce, Katherine E AU - Pierce KE AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Raman, Tina AU - Raman T AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Bortz, Cole AU - Bortz C AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Alas, Haddy AU - Alas H AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Brown, Avery AU - Brown A AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Ahmad, Waleed AU - Ahmad W AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Naessig, Sara AU - Naessig S AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Krol, Oscar AU - Krol O AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Passfall, Lara AU - Passfall L AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Kummer, Nicholas A AU - Kummer NA AD - Division of Spinal Surgery/Departments of Orthopedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY. FAU - Lafage, Renaud AU - Lafage R AD - Department of Orthopedics, Hospital for Special Surgery, New York, NY. FAU - Lafage, Virginie AU - Lafage V AD - Department of Orthopedics, Hospital for Special Surgery, New York, NY. LA - eng PT - Journal Article PL - United States TA - Spine (Phila Pa 1976) JT - Spine JID - 7610646 SB - IM MH - Adult MH - Female MH - Humans MH - Male MH - Patient Reported Outcome Measures MH - *Quality of Life MH - Retrospective Studies MH - *Spine MH - Treatment Outcome EDAT- 2021/08/27 06:00 MHDA- 2021/09/01 06:00 CRDT- 2021/08/26 12:23 PHST- 2021/08/26 12:23 [entrez] PHST- 2021/08/27 06:00 [pubmed] PHST- 2021/09/01 06:00 [medline] AID - 00007632-202109150-00010 [pii] AID - 10.1097/BRS.0000000000003999 [doi] PST - ppublish SO - Spine (Phila Pa 1976). 2021 Sep 15;46(18):1258-1263. doi: 10.1097/BRS.0000000000003999.