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Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis.

Publication ,  Journal Article
Schwab, FJ; Blondel, B; Bess, S; Hostin, R; Shaffrey, CI; Smith, JS; Boachie-Adjei, O; Burton, DC; Akbarnia, BA; Mundis, GM; Ames, CP ...
Published in: Spine (Phila Pa 1976)
June 1, 2013

STUDY DESIGN: Prospective multicenter study evaluating operative (OP) versus nonoperative (NONOP) treatment for adult spinal deformity (ASD). OBJECTIVE: Evaluate correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with ASD. SUMMARY OF BACKGROUND DATA: Sagittal spinal deformity is commonly defined by an increased sagittal vertical axis (SVA); however, SVA alone may underestimate the severity of the deformity. Spinopelvic parameters provide a more complete assessment of the sagittal plane but only limited data are available that correlate spinopelvic parameters with disability. METHODS.: Baseline demographic, radiographical, and HRQOL data were obtained for all patients enrolled in a multicenter consecutive database. Inclusion criteria were: age more than 18 years and radiographical diagnosis of ASD. Radiographical evaluation was conducted on the frontal and lateral planes and HRQOL questionnaires (Oswestry Disability Index [ODI], Scoliosis Research Society-22r and Short Form [SF]-12) were completed. Radiographical parameters demonstrating highest correlation with HRQOL values were evaluated to determine thresholds predictive of ODI more than 40. RESULTS: Four hundred ninety-two consecutive patients with ASD (mean age, 51.9 yr) were enrolled. Patients from the OP group (n = 178) were older (55 vs. 50.1 yr, P < 0.05), had greater SVA (5.5 vs. 1.7 cm, P < 0.05), greater pelvic tilt (PT; 22° vs. 11°, P < 0.05), and greater pelvic incidence/lumbar lordosis PI/LL mismatch (PI-LL; 12.2 vs. 4.3; P < 0.05) than NONOP group (n = 314). OP group demonstrated greater disability on all HRQOL measures compared with NONOP group (ODI = 41.4 vs. 23.9, P < 0.05; Scoliosis Research Society score total = 2.9 vs. 3.5, P < 0.05). Pearson analysis demonstrated that among all parameters, PT, SVA, and PI-LL correlated most strongly with disability for both OP and NONOP groups (P < 0.001). Linear regression models demonstrated threshold radiographical spinopelvic parameters for ODI more than 40 to be: PT 22° or more (r = 0.38), SVA 47 mm or more (r = 0.47), PI - LL 11° or more (r = 0.45). CONCLUSION: ASD is a disabling condition. Prospective analysis of consecutively enrolled patients with ASD demonstrated that PT and PI-LL combined with SVA can predict patient disability and provide a guide for patient assessment for appropriate therapeutic decision making. Threshold values for severe disability (ODI > 40) included: PT 22° or more, SVA 47 mm or more, and PI - LL 11° or more.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

June 1, 2013

Volume

38

Issue

13

Start / End Page

E803 / E812

Location

United States

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Spine
  • Sensitivity and Specificity
  • Scoliosis
  • Reproducibility of Results
  • Radiography
  • Quality of Life
  • Prospective Studies
  • Prognosis
 

Citation

APA
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ICMJE
MLA
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Schwab, F. J., Blondel, B., Bess, S., Hostin, R., Shaffrey, C. I., Smith, J. S., … International Spine Study Group (ISSG), . (2013). Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976), 38(13), E803–E812. https://doi.org/10.1097/BRS.0b013e318292b7b9
Schwab, Frank J., Benjamin Blondel, Shay Bess, Richard Hostin, Christopher I. Shaffrey, Justin S. Smith, Oheneba Boachie-Adjei, et al. “Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis.Spine (Phila Pa 1976) 38, no. 13 (June 1, 2013): E803–12. https://doi.org/10.1097/BRS.0b013e318292b7b9.
Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, et al. Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976). 2013 Jun 1;38(13):E803–12.
Schwab, Frank J., et al. “Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis.Spine (Phila Pa 1976), vol. 38, no. 13, June 2013, pp. E803–12. Pubmed, doi:10.1097/BRS.0b013e318292b7b9.
Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, Boachie-Adjei O, Burton DC, Akbarnia BA, Mundis GM, Ames CP, Kebaish K, Hart RA, Farcy J-P, Lafage V, International Spine Study Group (ISSG). Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976). 2013 Jun 1;38(13):E803–E812.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

June 1, 2013

Volume

38

Issue

13

Start / End Page

E803 / E812

Location

United States

Related Subject Headings

  • Young Adult
  • Surveys and Questionnaires
  • Spine
  • Sensitivity and Specificity
  • Scoliosis
  • Reproducibility of Results
  • Radiography
  • Quality of Life
  • Prospective Studies
  • Prognosis