PMID- 35604303
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240124
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 14
IP  - 2
DP  - 2024 Mar
TI  - Worse Preoperative Disability is Predictive of Improvement in Disability After 
      Complex Adult Spinal Deformity Surgery.
PG  - 364-369
LID - 10.1177/21925682221104425 [doi]
AB  - STUDY DESIGN: Retrospective Cohort Study. OBJECTIVES: Few previous studies have 
      examined the relationship between preoperative disability and patient outcomes 
      after complex adult spinal deformity surgery. In this study, we hypothesized that 
      patients with worse preoperative disability would be more likely achieve a 
      clinically significant improvement in their symptoms after surgery. METHODS: 
      Demographics, comorbidities, surgical data, and health related survey results 
      were analyzed from a consecutive series of adults (>/=18 years old) who underwent 
      spinal deformity correction, instrumentation, and fusion. Patients included had 6 
      or more levels fused and their surgery performed at single institution between 
      2015 and 2018 with minimum 2 year follow up. RESULTS: A total of 108 patients met 
      inclusion criteria. Bivariate analysis demonstrated the following as having a 
      greater probability of reaching minimum clinically important difference (MCID) at 
      2 years postoperatively: >50(th) percentile Oswestry Disability Index (ODI) score 
      (ODI >36), cardiac comorbidities, and use of pelvic fixation, pedicle subtraction 
      osteotomy, and transforaminal lumbar interbody fusion. Conversely, baseline 
      Scoliosis research society score (SRS) >50(th) percentile (SRS >/=62) and use of 
      vertebral column resection (VCR) were significant predictors of not reaching MCID 
      at 2 years. On logistic regression analysis, >50(th) percentile ODI score (ODI 
      >36) was identified as the only independent predictor of achieving MCID. 
      CONCLUSIONS: Patients with greater disability, independent of other preoperative 
      or surgical factors, are more likely to have clinically significant improvement 
      in their daily functioning after complex deformity surgery. For patients who 
      undergo surgical intervention for severe or progressive deformity, including VCR, 
      MCID might be an ineffective outcome measure.
FAU - Coury, Josephine R
AU  - Coury JR
AUID- ORCID: 0000-0002-4511-1172
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Morrissette, Cole R
AU  - Morrissette CR
AUID- ORCID: 0000-0001-5667-5056
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Lee, Nathan J
AU  - Lee NJ
AUID- ORCID: 0000-0001-9572-5968
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Cerpa, Meghan
AU  - Cerpa M
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Sardar, Zeeshan M
AU  - Sardar ZM
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Weidenbaum, Mark
AU  - Weidenbaum M
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Lehman, Ronald A
AU  - Lehman RA
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Lombardi, Joseph M
AU  - Lombardi JM
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
FAU - Lenke, Lawrence G
AU  - Lenke LG
AD  - Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical 
      Center, New York, NY, USA. RINGGOLD: 21611
LA  - eng
PT  - Journal Article
DEP - 20220523
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC10802541
OTO - NOTNLM
OT  - Oswestry disability index
OT  - complex deformity
OT  - health-related quality of life surveys
OT  - minimum clinically important difference
OT  - scoliosis research society
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2022/05/24 06:00
MHDA- 2022/05/24 06:01
PMCR- 2022/05/23
CRDT- 2022/05/23 09:42
PHST- 2022/05/24 06:01 [medline]
PHST- 2022/05/24 06:00 [pubmed]
PHST- 2022/05/23 09:42 [entrez]
PHST- 2022/05/23 00:00 [pmc-release]
AID - 10.1177_21925682221104425 [pii]
AID - 10.1177/21925682221104425 [doi]
PST - ppublish
SO  - Global Spine J. 2024 Mar;14(2):364-369. doi: 10.1177/21925682221104425. Epub 2022 
      May 23.