Scoliosis Corrective Surgery Impact on Health Related Quality of Life
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1 Scoliosis Corrective Surgery Impact on Health Related Quality of Life Boissiere L, Takemoto M, Cawley DT, Kieser D, Bourghli A, Yilgor C, Alanay A, Acaroglu E, Perez Grueso FJ, Pelisse F, Kleinstück F, Gille O, Vital JM, Obeid I European Spine Study Group, ESSG Bordeaux University Hospital, France
2 Introduction Scoliosis surgery in adults is indicated when function is impaired. The surgical goals are sagittal and coronal plane correction to achieve patient satisfaction (1). If surgery improves the Health Related Quality of life scores (HRQLs), this improvement remains limited after scoliosis surgery. The aim of this study was to evaluate the HRQL subclass variability after surgical correction sagittal and coronal plane changes.
3 Hypothesis Sagittal Alignment and Frontal Cobb Angle Restoration Impacts a Limited Number of HRQL Subclasses
4 Material and Methods Inclusion criteria Operated ASD patients Presenting at least one criteria: Cobb 20 ; SVA 5 cm; TK 60 or PT 25. Exclusion criteria Were all non scoliotic patients (Schwab coronal N) (2) Single level or decompressive surgeries. Parameters HRQLs items baseline, 1-year and 2-year Relative Spinopelvic Alignement (RSA) baseline, 1-year and 2-year Major Cobb angle (Cobb) baseline, 1-year and 2-year Demographic variables: age, gender, BMI
5 Relative SpinoPelvic Alignment (3) A single sagittal parameter is enough to evaluate the correlation between sagittal and HRQL (4)
6 Material and Methods Dependant variable: dhrql = HRQL postop HRQL preop Independent variable: drsa = RSA postop RSA preop, dcobb = Cobb postop Cobb preop, age, gender, BMI For each HRQL item we evaluate this multivariate analysis: dhrql = a x drsa + b x dcobb + c x Age + d x Gender + e x BMI
7 Results 202 and 118 patients reached 1-year and 2-year follow-up (FU) respectively. All HRQLs total scores were significantly improved postoperatively Preoperative SRS-22 total was 2.9 and 2 years-fu SRS-22 total was B0 AI N L LP LP LP LP B824 9 L LP LP LP LP B824 9COPML A OC LP LP LP LP B824 5 D L LP LP LP LP B824 I L LP LP LP LP B824 L LP LP LP LP B824 LB L LP LP LP LP B824 CCN L LP LP LP LP B824 CT DC LP ) LP * B824 MA DC LP LP LP LP B824 O SC L LP LP LP LP B824 M PAMOC LP LP LP LP ODI Sex Life item at 1-year and at 2-year were the only ODI items correlating with RSA variability No ODI items correlated with Cobb variability
8 B 3RLA ML /A S.... LP LP LP LP B 9 L LP LP LP LP B C D C LP LP ( B 6CL FC F LP LP LP LP B PD A ML LP (. LP * B R M PAMOC LP LP LP The HRQLs subclass variability was Never constantly (significant correlation at one and two year) correlated to dcobb Associated with drsa self-image and satisfaction from SRS-22 and appearance, vitality and mental health from SF B ) 0 AI PF NC LP - LP B 4L A M FCP LP ( LP ) (B 1 L PCSCO D F P MD P OP (. I L MOC F L C (F I L PCSCO MAIP ( 0 F L MO BOCPP L MLCPC D 7M. ) 7COSMRP 7MLC MD FC C. ( 3CC OCB 7MLC MD FC C.... LP LP LP LP LP LP * LP LP LP LC LP LP LP LC LP LP ( LP LP ( LC LP B 0MB N L LC SC LP LP LP B LC SC - LP B MA DRLA ML L LP LP LP B 6CL FC F LP LP
9 Discussion Coronal and sagittal plane variability impacts poorly on HRQLs changes. Self-Image and mental health are impacted by Adult Scoliosis correction but variability is related to sagittal plane changes. The major Cobb variability never correlated to HRQLs variability. ASD surgery is associated with patient satisfaction but its effectiveness appears limited when comparing HRQLs.
10 Conclusion These results need to be taken into account when planning surgery The correction of the major Cobb angle might not be the main goal in adult scoliosis.
11 References (1) Yoshida G, Boissiere L, Larrieu D, et al. Advantages and Disadvantages of Adult Spinal Deformity Surgery and Its Impact on Health-Related Quality of Life. Spine, 2017 Mar 15;42(6): (2) Schwab F, Ungar B, Blondel B, et al. Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study. Spine (Phila Pa 1976) 2012;37: (3) Yilgor C, Sogunmez N, Boissiere L, et al. Global Alignment and Proportion (GAP) Score Development and Validation of a New Method of Analyzing Spinopelvic Alignment to Predict Mechanical Complications after Adult Spinal Deformity Surgery. J Bone Joint Surg Am, 2017 Oct 4;99(19): (4) Boissiere L, Takemoto M, Bourghli A, et al. Global tilt and lumbar lordosis index: two parameters correlating with health-related quality of life scores-but how do they truly impact disability? Spine J 2017;17:480-8.
12 E-Poster # 45 Scoliosis Corrective Surgery Impact Louis Boissiere Mitsuru Takemoto Derek T Cawley David Kieser Anouar Bourghli Caglar Yilgor Ahmet Alanay Emre Acaroglu F-Javier Perez-Grueso Ferran Pellisé Frank Kleinstueck Olivier Gille Jean-Marc Vital Ibrahim Obeid European Spine Study G. Eurospine Barcelona Authors Disclosure Information (a) DePuy Synthes (e) Spineart (d) AO Spine; (a) DePuy Synthes; (a,d) Medtronic; (a,d) Stryker; (d) Zimmer; (c) IncredX (a,b) DePuy Synthes; (b) K2M (a,b) DePuy Synthes; (a) Medtronic; (b) Zimmer Biomet (a,b) DePuy Synthes (e) LDR; (e) Euros; (b, e) Kisco; (b) DePuy Synthes; (b) GlobalS (e) Alphatec Spine; (b) Medtronic; (a,b) DePuy Synthes; (e) Spineart; (e) Clariance (a) DePuy Synthes a. Grants/Research Support b. Consultant c. Stock/Shareholder d. Speakers Bureau e. Other Financial Support
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