Can Baseline Disability Predict Outcomes in Adult Spinal Deformity Surgery?

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2024-03, Vol.49 (6), p.398-404
• Main Authors: Passias, Peter G, Joujon-Roche, Rachel, Mir, Jamshaid M, Tretiakov, Peter, Dave, Pooja, Williamson, Tyler K, Imbo, Bailey, Krol, Oscar, Schoenfeld, Andrew J
• Format: Article
• Language: English
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0000000000004804

Retrospective Cohort Study. To assess if there is a threshold of baseline disability beyond which the patient-reported outcomes after surgical correction of adult spinal deformity (ASD) are adversely impacted. Patient-reported outcomes vary after correction of adult spinal deformity, even when patients are optimally realigned. There is a paucity of literature examining the impact of baseline disability on patient-reported outcomes in ASD. Patients with baseline (BL) and two-year data were included. Disability was ranked according to BL Oswestry Disability Index (ODI) into quintiles: Q1 (lowest ODI score) to Q5 (highest ODI score). Adjusted logistic regression analyses evaluated the likelihood of reaching ≥1 MCID in Scoliosis Research Society Outcomes Questionnaire (SRS-22) Pain, SRS-22 Activity, and Short Form-36 physical component summary at two years across disability groups Q1-Q4 with respect to Q5. Sensitivity tests were performed, excluding patients with any "0" Schwab modifiers at BL. Compared with patients in Q5, the odds of reaching MCID in SRS-22 Pain at 2Y were significantly higher for those in Q1 (OR: 3.771), Q2 (OR: 3.006), and Q3 (OR: 2.897), all P