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01-09-2018 | Original Article

Decision-making factors in the treatment of adult spinal deformity

Authors: Takashi Fujishiro, Louis Boissière, Derek Thomas Cawley, Daniel Larrieu, Olivier Gille, Jean-Marc Vital, Ferran Pellisé, Francisco Javier Sanchez Pérez-Grueso, Frank Kleinstück, Emre Acaroglu, Ahmet Alanay, Ibrahim Obeid, On behalf of European Spine Study Group, ESSG

Published in: European Spine Journal | Issue 9/2018

Abstract

Purpose

We aimed to elucidate the factors for the decision-making process in the treatment of adult spinal deformity (ASD), including sagittal parameters, that impact health-related quality of life (HRQOL).

Methods

A multicenter prospective ASD database was retrospectively reviewed. The demographic data, HRQOL, and radiographic measures were analyzed using multivariate analyses in younger (≤ 50 years) and older (> 50 years) age groups.

Results

This study included 414 patients (134 surgical and 280 nonsurgical; mean age 30.7 years) in the younger age group and 575 patients (323 surgical and 252 nonsurgical; mean age 65.8 years) in the older age group. Worse HRQOL measures drove surgical treatment, both in younger and older patients. The SRS-22 self-image score was the most differentiating domain, both in the younger and older age groups, and an additional significant factor in the older age group was pain and disability. Coronal deformity drove surgical treatment for the younger age group; however, older surgical patients were less likely to have coronal malalignment. Sagittal parameters were associated with the decision-making process. Greater pelvic incidence minus lumbar lordosis mismatch in the younger age group and smaller lumbar lordosis index in the older age group were most correlated with the decision to undergo surgery.

Conclusions

Aside from the HRQOL measures and coronal deformity, sagittal parameters were identified as significant factors for the decision-making process in the ASD population, and the lack of lumbar lordosis in relation to pelvic incidence was a strong driver to pursue surgical treatment.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Available only for authorised users

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Title: Decision-making factors in the treatment of adult spinal deformity
Authors: Takashi Fujishiro
Louis Boissière
Derek Thomas Cawley
Daniel Larrieu
Olivier Gille
Jean-Marc Vital
Ferran Pellisé
Francisco Javier Sanchez Pérez-Grueso
Frank Kleinstück
Emre Acaroglu
Ahmet Alanay
Ibrahim Obeid
On behalf of European Spine Study Group, ESSG
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 9/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5572-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Decision-making factors in the treatment of adult spinal deformity

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

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