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01-07-2019 | Original Article

Activities of daily living and patient satisfaction after long fusion for adult spinal deformity: a retrospective study

Authors: Yoshinori Ishikawa, Naohisa Miyakoshi, Takashi Kobayashi, Toshiki Abe, Hiroaki Kijima, Eiji Abe, Yoichi Shimada

Published in: European Spine Journal | Issue 7/2019

Abstract

Purpose

Spinal instrumented arthrodesis improves health-related quality of life (HRQOL), although mobility is impaired. This study evaluates activities of daily livings after thoracolumbosacroiliac arthrodesis for adult spinal deformity and patient satisfaction.

Methods

Fifty patients who underwent surgery filled self-administered questionnaires (1-year preoperative and postoperative conditions), and 36 patients (3 men and 33 women; mean age 71.4 years) participated in the study. Twenty-five activities, including weeding, snow shoveling, toilet activities, and sleeping postures, were examined. Spinal alignment with Scoliosis Research Society (SRS)—Schwab classification, HRQOL with SRS-22, complications, and patient satisfaction were evaluated. Pre- and postoperative conditions were statistically compared.

Results

Spinal alignment improved postoperatively. Comparison data revealed that strenuous activities, such as weeding and farm work, significantly deteriorated postoperatively in 42.1–87.5% patients. Other basic activities, excluding Western toilet usage, sleeping supine, laundry and kitchen chores, and changing jacket/pants, also significantly deteriorated in 21–88% patients. Only activities such as sleeping supine, standing upright, vacuuming, doing laundry, and reaching for objects placed at heights became possible with significant difference postoperatively among activities that could not be performed preoperatively. Light activities were continued, but strenuous activities were restricted. Nevertheless, the patient satisfaction rate was 70%. Six patients exhibited complications; however, none were dissatisfied with surgery outcomes. Instrumentation or proximal junctional failures were associated with at least one strenuous work activity.

Conclusions

Thoracolumbosacroiliac arthrodesis does not always improve activities postoperatively. Therefore, surgical indication for patients who continue activities preoperatively should be carefully decided.

Level of Evidence

Level 3.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Activities of daily living and patient satisfaction after long fusion for adult spinal deformity: a retrospective study
Authors: Yoshinori Ishikawa
Naohisa Miyakoshi
Takashi Kobayashi
Toshiki Abe
Hiroaki Kijima
Eiji Abe
Yoichi Shimada
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-05893-7

At a glance: The STEP trials

Springer Medicine

Activities of daily living and patient satisfaction after long fusion for adult spinal deformity: a retrospective study

Abstract

Purpose

Methods

Results

Conclusions

Level of Evidence

Graphical abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of Evidence

Graphical abstract

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