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Kyrölä K, Kautiainen H, Pekkanen L, Mäkelä P, Kiviranta I, Häkkinen A. Long-term clinical and radiographic outcomes and patient satisfaction after adult spinal deformity correction. Scand J Surg 2018; 108:343-351. [DOI: 10.1177/1457496918812201] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: Adult spinal deformity surgery has increased with the aging population and modern surgical approaches, although it has high complication and reoperation rates. The permanence of radiographic correction, mechanical complications, predictive factors for poor patient-reported outcomes, and patient satisfaction were analyzed. Material and Methods: A total of 79 adult patients were retrospectively analyzed at baseline and 1–9 years after adult spinal deformity correction between 2007 and 2016. Patient-reported outcomes (Oswestry Disability Index, visual analog scale, and Scoliosis Research Society–30 scores), changes in radiographic alignment, indications for reoperation, predictors of poor outcomes according to the Oswestry Disability Index and Scoliosis Research Society–30 scores, and patient satisfaction with management were studied. Results: Oswestry Disability Index and visual analog scale scores (p = 0.001), radiographic correction of thoracic kyphosis, lumbar lordosis, and pelvic retroversion (p ⩽ 0.001) and sagittal vertical axis (p = 0.043) were significantly better at 4–5 years of follow-up than at baseline. The risk for the first reoperation owing to mechanical failure of instrumentation or bone was highest within the first year, at 13.9% (95% confidence interval = 8.0%–23.7%), and 29.8% (95% confidence interval = 19.4%–43.9%) at the 5-year follow-up. Oswestry Disability Index and Scoliosis Research Society–30 total scores had a good correlation (r = −0.78; 95% CI = −0.86 to –0.68; p < 0.001). Satisfaction with management was correlated with patient-reported outcomes. Male sex and depression (p = 0.021 and 0.018, respectively) predicted poor outcomes according to the Oswestry Disability Index and/or Scoliosis Research Society–30 score. Conclusion: The achieved significant radiographic correction was maintained 5 years postoperatively. Despite reoperations, patient satisfaction and clinical outcomes were good. Depression and male sex predicted poor clinical outcomes.
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Affiliation(s)
- K. Kyrölä
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - H. Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - L. Pekkanen
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - P. Mäkelä
- Department of Orthopaedics and Traumatology, Oulu University Hospital, Oulu, Finland
| | - I. Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A. Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
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