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Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint.

Publication ,  Journal Article
Hart, RA; Hiratzka, J; Kane, MS; Lafage, V; Klineberg, E; Ames, CP; Line, BG; Schwab, F; Scheer, JK; Bess, S; Hamilton, DK; Shaffrey, CI ...
Published in: Spine (Phila Pa 1976)
August 1, 2017

STUDY DESIGN: Prospective, multicenter. OBJECTIVE: To determine if stiffness significantly affects function or satisfaction after pan-lumbar arthrodesis. SUMMARY OF BACKGROUND DATA: The Lumbar Stiffness Disability Index (LSDI) is a validated measure of the effect of lumbar stiffness on functional activities. Data suggests that patients undergoing fusion of the entire lumbar spine are at greatest risk of functional limitations from stiffness. METHODS: The LSDI, Short Form 36, Scoliosis Research Society-22, and Oswestry Disability Index were administered preoperatively and at 2-year minimum follow-up to 103 spinal deformity patients from 11 centers. Patients were separated according to the proximal arthrodesis level; upper thoracic (T2-5) to pelvis (UT-Pelvis) or thoraco-lumbar (T10-T12) to pelvis (TL-Pelvis). Outcome scores were compared using Student t test or Tukey-Kramer Honest Significant Difference Analysis of Variance. Regression analysis of final LSDI scores versus Scoliosis Research Society-22 Satisfaction scores was performed. RESULTS: Mean ages, baseline values, and final scores of all outcome parameters were statistically equivalent in the two groups. Final LSDI scores did not change significantly from baseline in the UT-Pelvis (P = 0.478) or TL-Pelvis (P = 0.301) groups. In contrast, highly significant improvements (P ≤ 0.0001) from baseline were seen in both groups for other health-related QoL measures. The 2-year Satisfaction scores were statistically equivalent in the two groups, and the correlation between final LSDI and Satisfaction scores in the entire cohort was not significant (R = 0.013, P = 0.146). CONCLUSION: Patients undergoing pan-lumbar arthrodesis for adult spinal deformity did not experience substantial increases in disability due to stiffness of the low back, although they did report significant improvements in other health-related QoL measures. Further, LSDI scores did not correlate with patient satisfaction. There were no significant differences in perceived stiffness effects whether arthrodesis stopped in the thoracolumbar or upper thoracic regions. We hope these results will be useful to spine surgeons and patients during preoperative planning and discussions. LEVEL OF EVIDENCE: 2.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

August 1, 2017

Volume

42

Issue

15

Start / End Page

1151 / 1157

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Diseases
  • Recovery of Function
  • Range of Motion, Articular
  • Prospective Studies
  • Patient Satisfaction
  • Orthopedics
  • Middle Aged
  • Male
 

Citation

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Hart, R. A., Hiratzka, J., Kane, M. S., Lafage, V., Klineberg, E., Ames, C. P., … International Spine Study Group, . (2017). Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint. Spine (Phila Pa 1976), 42(15), 1151–1157. https://doi.org/10.1097/BRS.0000000000002006
Hart, Robert A., Jayme Hiratzka, Marie S. Kane, Virginie Lafage, Eric Klineberg, Christopher P. Ames, Breton G. Line, et al. “Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint.Spine (Phila Pa 1976) 42, no. 15 (August 1, 2017): 1151–57. https://doi.org/10.1097/BRS.0000000000002006.
Hart RA, Hiratzka J, Kane MS, Lafage V, Klineberg E, Ames CP, et al. Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint. Spine (Phila Pa 1976). 2017 Aug 1;42(15):1151–7.
Hart, Robert A., et al. “Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint.Spine (Phila Pa 1976), vol. 42, no. 15, Aug. 2017, pp. 1151–57. Pubmed, doi:10.1097/BRS.0000000000002006.
Hart RA, Hiratzka J, Kane MS, Lafage V, Klineberg E, Ames CP, Line BG, Schwab F, Scheer JK, Bess S, Hamilton DK, Shaffrey CI, Mundis G, Smith JS, Burton DC, Sciubba DM, Deviren V, Boachie-Adjei O, International Spine Study Group. Stiffness After Pan-Lumbar Arthrodesis for Adult Spinal Deformity Does Not Significantly Impact Patient Functional Status or Satisfaction Irrespective of Proximal Endpoint. Spine (Phila Pa 1976). 2017 Aug 1;42(15):1151–1157.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

August 1, 2017

Volume

42

Issue

15

Start / End Page

1151 / 1157

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Diseases
  • Recovery of Function
  • Range of Motion, Articular
  • Prospective Studies
  • Patient Satisfaction
  • Orthopedics
  • Middle Aged
  • Male