Author/Authors :
bourghli, a. kingdom hospital, Riyadh, Saudi Arabia , larrieu, d. bordeaux pellegrin hospital, Bordeaux, France , boissière, l. bordeaux pellegrin hospital, Bordeaux, France , vital, j.-m. bordeaux pellegrin hospital, Bordeaux, France , pellisé, f. hospital universitario val hebron, Barcelona, Spain , alanay, a. acibadem maslak hospital, Istanbul, Turkey , acaroglu, e. ankara acibadem spine center, Ankara, Turkey , perez-grueso, f.-j. hospital universitario la paz, Madrid, Spain , kleinstück, f. schulthess klinik - spine center, Zurich, Switzerland , obeid, i. bordeaux pellegrin hospital, Bordeaux, France
Abstract :
Purpose : Sagittal parameters do not have the same fluctuation and accuracy during adult spinal deformity (ASD) surgery follow-up.The relationship between sagittal radiographic parameters and health related quality of life (HRQoL) scores is well known in ASD. Sagittal vertical axis (SVA) and pelvic tilt (PT) are commonly used. Global tilt (GT) was recently added as an angle for the assessment of the global spinopelvic alignment. HRQoL scores and sagittal radiographic parameters’ fluctuations during the postoperative period have not been yet described. This study aimed to evaluate the fluctuations of HRQoL scores and radiographic sagittal parameters during the postoperative follow-up in ASD patients. Methods : This is a multicenter, retrospective study of consecutive operated ASD patients included prospectively with a minimum follow-up of 2 years. Preoperative, 6 months, 1 year and 2 years postoperative data were analyzed. Pearson correlation analysis was performed and accuracy of all parameters was determined by the measurement of statistical fluctuation within the sample;p 0.05 was considered significant. Results: A total of 91 patients were included. All parameters improved at 6M post-op (p 0.05) and no parameter changed between 1Y and 2Y post-op. GT (GT6M = 18.57, GT1Y = 20.46, p = 0.024), SF-36 PCS (PCS6M = 39.13, PCS1Y= 41.54, p = 0.002) and ODI (ODI6M = 34.43, ODI1Y = 30.08, p = 0.009) significantly changed between 6M and 1Y. No significant difference was found concerning SVA (SVA6M = 7.12, SVA1Y = 12.15). SVA fluctuation (SVA6M = 147.86%, SVA1Y = 83.76%, SVA2Y = 71.77%) was larger than GT (GT6M = 18.76%, GT1Y = 17.27%, GT2Y = 17.45%), PT (PT6M = 24.32%, PT1Y = 23.38%, PT2Y = 22.80%), SF-36 PCS (PCS6M = 4.74%, PCS1Y = 4.81%, PCS2Y = 5.10%) and ODI (ODI6M = 11.47%, ODI1Y = 13.11%, ODI2Y = 14.41%). Conclusions: GT was the only radiographic parameter that significantly changed between 6 months and 1 year. Its changes were parallel to HRQoL score modifications. All sagittal parameters did not have the same accuracy and precision for ASD surgery follow-up. Despite the large difference in the mean value of SVA at 6 months and 1 year, it is not a good parameter for follow-up because of its large fluctuations. GT has the highest precision and should be used for this purpose.
NaturalLanguageKeyword :
adult spinal deformity , fluctuations , health related quality of life scores , sagittal parameters
