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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Impact of New Motor Deficit on HRQOL after Adult Spinal Deformity Surgery: Subanalysis from Scoli Risk 1 Prospective Study

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  • 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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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.

Original languageEnglish
JournalSpine
Volume46
Issue number7
Pages (from-to)E450-E457
ISSN0362-2436
DOIs
Publication statusPublished - 1 Apr 2021

ID: 62386365