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Ability of the Global Alignment and Proportion Score to Predict Mechanical Failure Following Adult Spinal Deformity Surgery-Validation in 149 Patients With Two-Year Follow-up

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Revision Risk After Primary Adult Spinal Deformity Surgery: A Nationwide Study With Two-Year Follow-up

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Sagittal Alignment After Surgical Treatment of Adolescent Idiopathic Scoliosis-Application of the Roussouly Classification

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Evaluation of a new sagittal classification system in adolescent idiopathic scoliosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Use of Opioids and Other Analgesics Before and After Primary Surgery for Adult Spinal Deformity: A 10-Year Nationwide Study

    Research output: Contribution to journalJournal articleResearchpeer-review

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STUDY DESIGN: Retrospective analysis of prospectively collected data.

OBJECTIVES: To validate the Global Alignment and Proportion (GAP) score in a single-center cohort of adult spinal deformity (ASD) patients. Surgical treatment for ASD is associated with a high risk of mechanical failure and consequent revision surgery. To improve prediction of mechanical complications, the GAP score was developed with promising results. Development was based on the assumption that not all patients would benefit from the same fixed radiographic targets as pelvic incidence is an individual, morphological parameter that greatly influences the sagittal curves of the spine.

METHODS: In a validation study of the GAP score, patients undergoing ASD surgery with four or more levels of instrumentation were consecutively included at a tertiary spine unit. Patients were followed for a minimum of two years. Pre- and postoperative GAP score and categories were calculated for all patients, and the association with mechanical failure and revision surgery was analyzed.

RESULTS: A total of 149 patients with a mean age of 57.4 years were included. Overall, the rates of mechanical failure and revision surgery were 51% and 35% respectively. The area under the curve (AUC) using receiver operating characteristic was classified as "no or low discriminatory power" for the GAP score in predicting either outcome (AUC = 0.50 and 0.49, respectively). Similarly, there were no significant associations between GAP categories and the occurrence of mechanical failure or revision surgery when using Cochran-Armitage test of trend (p = .28 for mechanical failure and p = .58 for revision surgery).

CONCLUSIONS: In a consecutive series of surgically treated ASD patients, we found no significant association between postoperative GAP score and mechanical failure or revision surgery. Despite minor limitations in similarities to the original study cohort, further validation studies or adjustments to the original scoring system are proposed.

LEVEL OF EVIDENCE: Level II.

Original languageEnglish
JournalSpine Deformity
Volume7
Issue number2
Pages (from-to)331-337
Number of pages7
ISSN2212-134X
DOIs
Publication statusPublished - Mar 2019

ID: 59371130