Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study

Rajiv Saigal; Darryl Lau; Sigurd H Berven; Leah Carreon; Mark B Dekutoski; Khaled M Kebaish; Yong Qiu; Yukihiro Matsuyama; Michael Kelly; Benny T Dahl; Hossein Mehdian; Ferran Pellisé; Stephen J Lewis; Kenneth Mc Cheung; Christopher I Shaffrey; Michael G Fehlings; Lawrence G Lenke; Christopher P Ames; AOSpine Knowledge Forum Deformity

doi:10.1097/BRS.0000000000003852

Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study

Rajiv Saigal, Darryl Lau, Sigurd H Berven, Leah Carreon, Mark B Dekutoski, Khaled M Kebaish, Yong Qiu, Yukihiro Matsuyama, Michael Kelly, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Stephen J Lewis, Kenneth Mc Cheung, Christopher I Shaffrey, Michael G Fehlings, Lawrence G Lenke, Christopher P Ames, AOSpine Knowledge Forum Deformity

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Abstract

STUDY DESIGN: International, multi-center, prospective, longitudinal observational cohort.

OBJECTIVE: To assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.

SUMMARY OF BACKGROUND DATA: Adult spinal deformity surgery is associated with high morbidity, including risk of new post-operative motor deficit. It is unclear what effect new motor deficit has on HRQOL scores.

METHODS: Adult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb >80 degrees, C7-L2 curve apex, and any patient undergoing 3 column osteotomy. ASIA scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.

RESULTS: 272 complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower LEMS scores. Mean HRQOL changes at 6 weeks and 2 years compared to pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and -4.7 at 2 years), SF-36v2 physical (-4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and -12.1 at 2 years), SF-36v2 physical (-1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (-0.6 at 6 weeks and -16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).

CONCLUSION: In the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared to pre-op baseline.

LEVEL OF EVIDENCE: 3.

Originalsprog	Engelsk
Tidsskrift	Spine
Vol/bind	46
Udgave nummer	7
Sider (fra-til)	E450-E457
ISSN	0362-2436
DOI	https://doi.org/10.1097/BRS.0000000000003852
Status	Udgivet - 1 apr. 2021

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10.1097/BRS.0000000000003852

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Saigal, R., Lau, D., Berven, S. H., Carreon, L., Dekutoski, M. B., Kebaish, K. M., Qiu, Y., Matsuyama, Y., Kelly, M., Dahl, B. T., Mehdian, H., Pellisé, F., Lewis, S. J., Cheung, K. M., Shaffrey, C. I., Fehlings, M. G., Lenke, L. G., Ames, C. P., & AOSpine Knowledge Forum Deformity (2021). Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study. Spine, 46(7), E450-E457. https://doi.org/10.1097/BRS.0000000000003852

Saigal, R, Lau, D, Berven, SH, Carreon, L, Dekutoski, MB, Kebaish, KM, Qiu, Y, Matsuyama, Y, Kelly, M, Dahl, BT, Mehdian, H, Pellisé, F, Lewis, SJ, Cheung, KM, Shaffrey, CI, Fehlings, MG, Lenke, LG, Ames, CP & AOSpine Knowledge Forum Deformity 2021, 'Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study', Spine, bind 46, nr. 7, s. E450-E457. https://doi.org/10.1097/BRS.0000000000003852

@article{2a0b989777ba4844b55b1400c0abbda7,

title = "Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study",

abstract = "STUDY DESIGN: International, multi-center, prospective, longitudinal observational cohort.OBJECTIVE: To assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.SUMMARY OF BACKGROUND DATA: Adult spinal deformity surgery is associated with high morbidity, including risk of new post-operative motor deficit. It is unclear what effect new motor deficit has on HRQOL scores.METHODS: Adult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb >80 degrees, C7-L2 curve apex, and any patient undergoing 3 column osteotomy. ASIA scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.RESULTS: 272 complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower LEMS scores. Mean HRQOL changes at 6 weeks and 2 years compared to pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and -4.7 at 2 years), SF-36v2 physical (-4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and -12.1 at 2 years), SF-36v2 physical (-1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (-0.6 at 6 weeks and -16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).CONCLUSION: In the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared to pre-op baseline.LEVEL OF EVIDENCE: 3.",

author = "Rajiv Saigal and Darryl Lau and Berven, {Sigurd H} and Leah Carreon and Dekutoski, {Mark B} and Kebaish, {Khaled M} and Yong Qiu and Yukihiro Matsuyama and Michael Kelly and Dahl, {Benny T} and Hossein Mehdian and Ferran Pellis{\'e} and Lewis, {Stephen J} and Cheung, {Kenneth Mc} and Shaffrey, {Christopher I} and Fehlings, {Michael G} and Lenke, {Lawrence G} and Ames, {Christopher P} and {AOSpine Knowledge Forum Deformity}",

year = "2021",

month = apr,

day = "1",

doi = "10.1097/BRS.0000000000003852",

language = "English",

volume = "46",

pages = "E450--E457",

journal = "Spine",

issn = "0362-2436",

publisher = "Lippincott Williams & Wilkins",

number = "7",

}

TY - JOUR

T1 - Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery

T2 - Subanalysis from Scoli Risk 1 Prospective Study

AU - Saigal, Rajiv

AU - Lau, Darryl

AU - Berven, Sigurd H

AU - Carreon, Leah

AU - Dekutoski, Mark B

AU - Kebaish, Khaled M

AU - Qiu, Yong

AU - Matsuyama, Yukihiro

AU - Kelly, Michael

AU - Dahl, Benny T

AU - Mehdian, Hossein

AU - Pellisé, Ferran

AU - Lewis, Stephen J

AU - Cheung, Kenneth Mc

AU - Shaffrey, Christopher I

AU - Fehlings, Michael G

AU - Lenke, Lawrence G

AU - Ames, Christopher P

AU - AOSpine Knowledge Forum Deformity

PY - 2021/4/1

Y1 - 2021/4/1

N2 - STUDY DESIGN: International, multi-center, prospective, longitudinal observational cohort.OBJECTIVE: To assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.SUMMARY OF BACKGROUND DATA: Adult spinal deformity surgery is associated with high morbidity, including risk of new post-operative motor deficit. It is unclear what effect new motor deficit has on HRQOL scores.METHODS: Adult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb >80 degrees, C7-L2 curve apex, and any patient undergoing 3 column osteotomy. ASIA scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.RESULTS: 272 complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower LEMS scores. Mean HRQOL changes at 6 weeks and 2 years compared to pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and -4.7 at 2 years), SF-36v2 physical (-4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and -12.1 at 2 years), SF-36v2 physical (-1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (-0.6 at 6 weeks and -16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).CONCLUSION: In the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared to pre-op baseline.LEVEL OF EVIDENCE: 3.

AB - STUDY DESIGN: International, multi-center, prospective, longitudinal observational cohort.OBJECTIVE: To assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.SUMMARY OF BACKGROUND DATA: Adult spinal deformity surgery is associated with high morbidity, including risk of new post-operative motor deficit. It is unclear what effect new motor deficit has on HRQOL scores.METHODS: Adult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb >80 degrees, C7-L2 curve apex, and any patient undergoing 3 column osteotomy. ASIA scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.RESULTS: 272 complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower LEMS scores. Mean HRQOL changes at 6 weeks and 2 years compared to pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and -4.7 at 2 years), SF-36v2 physical (-4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and -12.1 at 2 years), SF-36v2 physical (-1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (-0.6 at 6 weeks and -16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).CONCLUSION: In the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared to pre-op baseline.LEVEL OF EVIDENCE: 3.

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U2 - 10.1097/BRS.0000000000003852

DO - 10.1097/BRS.0000000000003852

M3 - Journal article

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SN - 0362-2436

VL - 46

SP - E450-E457

JO - Spine

JF - Spine

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ER -

Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study

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