Operative treatment for adult spinal deformity (ASD) provides significant improvement in health-related quality of life at minimum three-year follow-up (mean 4.1 years), suggesting that the benefits of surgery for ASD remain durable long term. This is the key message to come out of a recent study which was published in the Journal of Neurosurgery: Spine by Elias Elias (University of Virginia, Charlottesville, USA) et al.
The researchers note that the findings of this prospective multicentre analysis “should prove useful for counselling, cost-effectiveness assessments, and efforts to improve the safety of care”.
They state that longer term durability is important given the invasiveness, complications, and costs of these procedures and so the aim of the study was to assess minimum three-year outcomes and complications of ASD surgery.
Operatively treated ASD patients were assessed at baseline, follow-up, and through mailings. Patient-reported outcome measures (PROMs) included scores on the Oswestry Disability Index (ODI), Scoliosis Research Society–22r (SRS-22r) questionnaire, mental component summary (MCS) and physical component summary (PCS) of the SF-36, and numeric rating scale (NRS) for back and leg pain.
Complications were classified as perioperative (≤ 90 days), delayed (90 days to two years), and long term (≥ two years). Analyses focused on patients with minimum three-year follow-up.
Out of a total of 569 patients, 427 (75%) with minimum three-year follow-up (mean ± standard deviation [range] 4.1 ± 1.1 [3–9.6] years) had a mean age of 60.8 years and 75% were women. Operative treatment included a posterior approach for 426 patients (99%), with a mean ± standard deviation (SD) 12 ± 4 fusion levels. Anterior lumbar interbody fusion was performed in 35 (8%) patients, and 89 (21%) underwent three-column osteotomy.
The study found that all PROMs improved significantly (p