Spine (Phila Pa 1976) 2020 Dec 17;Publish Ahead of Print. Epub 2020 Dec 17.
Norton Leatherman Spine Center, 210 East Gray Street, Louisville, KY 40202 Inova Loudoun Hospital, Lansdowne, VA 2017 Sarah Cannon Research Institute, Nashville, TN 37203 Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, Texas Department of Orthopaedic Surgery, Washington University, St Louis, Missouri Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York Department of Neurosurgery, University of Virginia, Charlottesville, Virginia Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland Department of Orthopaedic Surgery, Spine Division, Duke University Medical Center Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas Department of Neurological Surgery, University of California, San Francisco, San Francisco, California Presbyterian/St. Luke's Medical Center, Rocky Mountain Hospital for Children, Denver, Colorado International Spine Study Group Foundation, Brighton, Colorado.
Study Design: Longitudinal Cohort.
Objectives: To examine the relationship between patient satisfaction, Patient Reported Outcome Measures (PROMs) and radiographic parameters in Adult Spine Deformity (ASD) patients undergoing 3 Column Osteotomies (3CO).
Summary Of Background Data: Identifying factors that influence patient satisfaction in ASD is important. Evidence suggests SRS22R Self-Image domain correlates with patient satisfaction in patients with ASD.
Methods: This is a retrospective review of ASD patients enrolled in a prospective, multicenter database undergoing a 3CO with complete SRS22R pre-op and minimum 2-years postop. Spearman correlations were used to evaluate associations between the 2-yr SRS Satisfaction score and changes in SRS22R domain scores, Oswestry Disability Index (ODI), and radiographic parameters.
Results: Of 135 patients eligible for 2-year follow-up, 98 patients (73%) had complete pre- and 2-yr postop data. The cohort was mostly female (69%) with mean BMI of 29.7 kg/m2 and age of 61.0 yrs. Mean levels fused was 12.9 with EBL of 2695cc and OR time of 407 minutes; 27% were revision surgeries. There was a statistically significant improvement between pre- and 2-year post-op PROMs and all radiographic parameters except Coronal Vertical Axis. The majority of patients had an SRS Satisfaction score of ≥ 3.0 (90%) or ≥ 4.0 (68%), consistent with a moderate ceiling effect. Correlations of patient satisfaction was significant for Pain (0.43, p < 0.001), Activity (0.39, p < 0.001), Mental (0.38, p = 0.001) Self-Image (0.52, p < 0.001). ODI and SF-36 PCS had a moderate correlation as well, with MCS being weak. There was no statistically significant correlations between any radiographic or operative parameters and patient satisfaction.
Conclusion: There was statistically significant improvement in all PROMs and radiographic parameters, except CVA at 2-years in ASD patients undergoing 3CO. Improvement in SRS Self-Image domain has the strongest correlation with patient satisfaction.Level of Evidence: 3.