Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; However, deformities differ between age groups

Kai Ming G Fu, Shay Bess, Christopher I. Shaffrey, Justin S. Smith, Virginie Lafage, Frank Schwab, Douglas C. Burton, Behrooz A. Akbarnia, Christopher P. Ames, Oheneba Boachie-Adjei, Vedat Deverin, Robert A. Hart, Richard Hostin, Eric Otto Klineberg, Munish Gupta, Khaled Kebaish, Gregory Mundis, Praveen V. Mummaneni

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Abstract

STUDY DESIGN.: Multicenter, prospective analysis of consecutive patients with adult spinal deformity (ASD). OBJECTIVE.: Identify age-related radiographical parameters associated with poor health-related quality of life (HRQOL) and treatment preferences for ASD. SUMMARY OF BACKGROUND DATA.: Patients with ASD report discrepant severities of disability. Understanding age-associated differences for reported disability and treatment preferences may improve ASD evaluation and treatment. METHODS.: Baseline demographic, radiographical, and HRQOL values were evaluated in a multicenter, prospective cohort of consecutive patients with ASD. Inclusion criteria: ASD, age more than 18 years, and no prior spine surgery. Patients were grouped into those treated operatively (OP) or nonoperatively (NON) and stratified into 3 age groups: G1, 50 years or less; G2, 50 to 65 years; G3, 65 years or more. HRQOL measures included Scoliosis Research Society-22r questionnaire, Oswestry Disability Index, and Short Form-36 Health Survey. RESULTS.: Four hundred ninety-seven patients (OP = 156, NON = 341) with a mean age of 50.4 years met inclusion criteria. The OP group was older (53.3 vs. 49.0 yr), had larger scoliosis (49.3° vs. 43.3°), larger sagittal vertical axis (SVA, 33.2 vs. 13.7 mm), greater pelvic incidence-lumbar lordosis mismatch (6.6°vs. 3.1°), and worse HRQOL scores than the NON group, respectively (P < 0.05). Age stratification demonstrated worsening of SVA, spinopelvic alignment (SPA), and HRQOL scores with increasing age (P < 0.05). Age/treatment stratification demonstrated that younger OP had greater scoliosis than NON (G1OP = 49.9°vs. G1NON = 42.2°; G2OP = 56°vs. G2NON = 47.2°; P < 0.05) but similar SPA as NON. Older OP had similar scoliosis, but larger SVA than NON (G3OP = 100.6 vs. G3NON = 66.4 mm; P < 0.05). OP in all age groups reported worse HRQOL than NON (P < 0.05). CONCLUSION.: Poor HRQOL uniformly determined operative treatment for ASD. Spinal deformities differed between age groups. Younger OP had larger scoliosis but similar SPA and SVA than NON. Older OP had similar scoliosis but worse SVA than NON. Age-associated differences for poor HRQOL must be considered when evaluating patients with ASD.

Original languageEnglish (US)
Pages (from-to)1401-1407
Number of pages7
JournalSpine
Volume39
Issue number17
DOIs
StatePublished - Aug 1 2014

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Scoliosis
Age Groups
Quality of Life
Pain
Therapeutics
Lordosis
Health Surveys
Spine
Demography
Incidence
Research

Keywords

  • adult spinal deformity
  • disability
  • nonoperative treatment
  • surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; However, deformities differ between age groups. / Fu, Kai Ming G; Bess, Shay; Shaffrey, Christopher I.; Smith, Justin S.; Lafage, Virginie; Schwab, Frank; Burton, Douglas C.; Akbarnia, Behrooz A.; Ames, Christopher P.; Boachie-Adjei, Oheneba; Deverin, Vedat; Hart, Robert A.; Hostin, Richard; Klineberg, Eric Otto; Gupta, Munish; Kebaish, Khaled; Mundis, Gregory; Mummaneni, Praveen V.

In: Spine, Vol. 39, No. 17, 01.08.2014, p. 1401-1407.

Research output: Contribution to journalArticle

Fu, KMG, Bess, S, Shaffrey, CI, Smith, JS, Lafage, V, Schwab, F, Burton, DC, Akbarnia, BA, Ames, CP, Boachie-Adjei, O, Deverin, V, Hart, RA, Hostin, R, Klineberg, EO, Gupta, M, Kebaish, K, Mundis, G & Mummaneni, PV 2014, 'Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; However, deformities differ between age groups', Spine, vol. 39, no. 17, pp. 1401-1407. https://doi.org/10.1097/BRS.0000000000000414
Fu, Kai Ming G ; Bess, Shay ; Shaffrey, Christopher I. ; Smith, Justin S. ; Lafage, Virginie ; Schwab, Frank ; Burton, Douglas C. ; Akbarnia, Behrooz A. ; Ames, Christopher P. ; Boachie-Adjei, Oheneba ; Deverin, Vedat ; Hart, Robert A. ; Hostin, Richard ; Klineberg, Eric Otto ; Gupta, Munish ; Kebaish, Khaled ; Mundis, Gregory ; Mummaneni, Praveen V. / Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; However, deformities differ between age groups. In: Spine. 2014 ; Vol. 39, No. 17. pp. 1401-1407.
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abstract = "STUDY DESIGN.: Multicenter, prospective analysis of consecutive patients with adult spinal deformity (ASD). OBJECTIVE.: Identify age-related radiographical parameters associated with poor health-related quality of life (HRQOL) and treatment preferences for ASD. SUMMARY OF BACKGROUND DATA.: Patients with ASD report discrepant severities of disability. Understanding age-associated differences for reported disability and treatment preferences may improve ASD evaluation and treatment. METHODS.: Baseline demographic, radiographical, and HRQOL values were evaluated in a multicenter, prospective cohort of consecutive patients with ASD. Inclusion criteria: ASD, age more than 18 years, and no prior spine surgery. Patients were grouped into those treated operatively (OP) or nonoperatively (NON) and stratified into 3 age groups: G1, 50 years or less; G2, 50 to 65 years; G3, 65 years or more. HRQOL measures included Scoliosis Research Society-22r questionnaire, Oswestry Disability Index, and Short Form-36 Health Survey. RESULTS.: Four hundred ninety-seven patients (OP = 156, NON = 341) with a mean age of 50.4 years met inclusion criteria. The OP group was older (53.3 vs. 49.0 yr), had larger scoliosis (49.3° vs. 43.3°), larger sagittal vertical axis (SVA, 33.2 vs. 13.7 mm), greater pelvic incidence-lumbar lordosis mismatch (6.6°vs. 3.1°), and worse HRQOL scores than the NON group, respectively (P < 0.05). Age stratification demonstrated worsening of SVA, spinopelvic alignment (SPA), and HRQOL scores with increasing age (P < 0.05). Age/treatment stratification demonstrated that younger OP had greater scoliosis than NON (G1OP = 49.9°vs. G1NON = 42.2°; G2OP = 56°vs. G2NON = 47.2°; P < 0.05) but similar SPA as NON. Older OP had similar scoliosis, but larger SVA than NON (G3OP = 100.6 vs. G3NON = 66.4 mm; P < 0.05). OP in all age groups reported worse HRQOL than NON (P < 0.05). CONCLUSION.: Poor HRQOL uniformly determined operative treatment for ASD. Spinal deformities differed between age groups. Younger OP had larger scoliosis but similar SPA and SVA than NON. Older OP had similar scoliosis but worse SVA than NON. Age-associated differences for poor HRQOL must be considered when evaluating patients with ASD.",
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TY - JOUR

T1 - Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; However, deformities differ between age groups

AU - Fu, Kai Ming G

AU - Bess, Shay

AU - Shaffrey, Christopher I.

AU - Smith, Justin S.

AU - Lafage, Virginie

AU - Schwab, Frank

AU - Burton, Douglas C.

AU - Akbarnia, Behrooz A.

AU - Ames, Christopher P.

AU - Boachie-Adjei, Oheneba

AU - Deverin, Vedat

AU - Hart, Robert A.

AU - Hostin, Richard

AU - Klineberg, Eric Otto

AU - Gupta, Munish

AU - Kebaish, Khaled

AU - Mundis, Gregory

AU - Mummaneni, Praveen V.

PY - 2014/8/1

Y1 - 2014/8/1

N2 - STUDY DESIGN.: Multicenter, prospective analysis of consecutive patients with adult spinal deformity (ASD). OBJECTIVE.: Identify age-related radiographical parameters associated with poor health-related quality of life (HRQOL) and treatment preferences for ASD. SUMMARY OF BACKGROUND DATA.: Patients with ASD report discrepant severities of disability. Understanding age-associated differences for reported disability and treatment preferences may improve ASD evaluation and treatment. METHODS.: Baseline demographic, radiographical, and HRQOL values were evaluated in a multicenter, prospective cohort of consecutive patients with ASD. Inclusion criteria: ASD, age more than 18 years, and no prior spine surgery. Patients were grouped into those treated operatively (OP) or nonoperatively (NON) and stratified into 3 age groups: G1, 50 years or less; G2, 50 to 65 years; G3, 65 years or more. HRQOL measures included Scoliosis Research Society-22r questionnaire, Oswestry Disability Index, and Short Form-36 Health Survey. RESULTS.: Four hundred ninety-seven patients (OP = 156, NON = 341) with a mean age of 50.4 years met inclusion criteria. The OP group was older (53.3 vs. 49.0 yr), had larger scoliosis (49.3° vs. 43.3°), larger sagittal vertical axis (SVA, 33.2 vs. 13.7 mm), greater pelvic incidence-lumbar lordosis mismatch (6.6°vs. 3.1°), and worse HRQOL scores than the NON group, respectively (P < 0.05). Age stratification demonstrated worsening of SVA, spinopelvic alignment (SPA), and HRQOL scores with increasing age (P < 0.05). Age/treatment stratification demonstrated that younger OP had greater scoliosis than NON (G1OP = 49.9°vs. G1NON = 42.2°; G2OP = 56°vs. G2NON = 47.2°; P < 0.05) but similar SPA as NON. Older OP had similar scoliosis, but larger SVA than NON (G3OP = 100.6 vs. G3NON = 66.4 mm; P < 0.05). OP in all age groups reported worse HRQOL than NON (P < 0.05). CONCLUSION.: Poor HRQOL uniformly determined operative treatment for ASD. Spinal deformities differed between age groups. Younger OP had larger scoliosis but similar SPA and SVA than NON. Older OP had similar scoliosis but worse SVA than NON. Age-associated differences for poor HRQOL must be considered when evaluating patients with ASD.

AB - STUDY DESIGN.: Multicenter, prospective analysis of consecutive patients with adult spinal deformity (ASD). OBJECTIVE.: Identify age-related radiographical parameters associated with poor health-related quality of life (HRQOL) and treatment preferences for ASD. SUMMARY OF BACKGROUND DATA.: Patients with ASD report discrepant severities of disability. Understanding age-associated differences for reported disability and treatment preferences may improve ASD evaluation and treatment. METHODS.: Baseline demographic, radiographical, and HRQOL values were evaluated in a multicenter, prospective cohort of consecutive patients with ASD. Inclusion criteria: ASD, age more than 18 years, and no prior spine surgery. Patients were grouped into those treated operatively (OP) or nonoperatively (NON) and stratified into 3 age groups: G1, 50 years or less; G2, 50 to 65 years; G3, 65 years or more. HRQOL measures included Scoliosis Research Society-22r questionnaire, Oswestry Disability Index, and Short Form-36 Health Survey. RESULTS.: Four hundred ninety-seven patients (OP = 156, NON = 341) with a mean age of 50.4 years met inclusion criteria. The OP group was older (53.3 vs. 49.0 yr), had larger scoliosis (49.3° vs. 43.3°), larger sagittal vertical axis (SVA, 33.2 vs. 13.7 mm), greater pelvic incidence-lumbar lordosis mismatch (6.6°vs. 3.1°), and worse HRQOL scores than the NON group, respectively (P < 0.05). Age stratification demonstrated worsening of SVA, spinopelvic alignment (SPA), and HRQOL scores with increasing age (P < 0.05). Age/treatment stratification demonstrated that younger OP had greater scoliosis than NON (G1OP = 49.9°vs. G1NON = 42.2°; G2OP = 56°vs. G2NON = 47.2°; P < 0.05) but similar SPA as NON. Older OP had similar scoliosis, but larger SVA than NON (G3OP = 100.6 vs. G3NON = 66.4 mm; P < 0.05). OP in all age groups reported worse HRQOL than NON (P < 0.05). CONCLUSION.: Poor HRQOL uniformly determined operative treatment for ASD. Spinal deformities differed between age groups. Younger OP had larger scoliosis but similar SPA and SVA than NON. Older OP had similar scoliosis but worse SVA than NON. Age-associated differences for poor HRQOL must be considered when evaluating patients with ASD.

KW - adult spinal deformity

KW - disability

KW - nonoperative treatment

KW - surgery

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U2 - 10.1097/BRS.0000000000000414

DO - 10.1097/BRS.0000000000000414

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