Skip to main content
Journal cover image

Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery?

Publication ,  Journal Article
Park, P; Okonkwo, DO; Nguyen, S; Mundis, GM; Than, KD; Deviren, V; La Marca, F; Fu, K-M; Wang, MY; Uribe, JS; Anand, N; Fessler, R; Chou, D ...
Published in: World Neurosurg
February 2016

BACKGROUND: Older age has been considered a relative contraindication to complex spinal procedures. Minimally invasive surgery (MIS) techniques to treat patients with adult spinal deformity (ASD) have emerged with the potential benefit of decreased approach-related morbidity. OBJECTIVE: To determine whether a minimal clinically important difference (MCID) could be achieved in patients ages ≥ 65 years with ASD who underwent MIS. METHODS: Multicenter database of patients who underwent MIS for ASD was queried. Outcome metrics assessed were Oswestry Disability Index (ODI) and visual analog scale (VAS) scores for back and leg pain. On the basis of published reports, MCID was defined as a positive change of 12.8 ODI, 1.2 VAS back pain, and 1.6 VAS leg pain. RESULTS: Forty-two patients were identified. Mean age was 70.3 years; 31 (73.8%) were women. Preoperatively, mean coronal curve, pelvic tilt, pelvic incidence to lumbar lordosis mismatch, and sagittal vertical axis were 35°, 24.6°, 14.2°, and 4.7 cm, respectively. Postoperatively, mean coronal curve, pelvic tilt, pelvic incidence to lumbar lordosis, and sagittal vertical axis were 18°, 25.4°, 11.9°, and 4.9 cm, respectively. A mean of 5.0 levels was treated posteriorly, and a mean of 4.0 interbody fusions was performed. Mean ODI improved from 47.1 to 25.1. Mean VAS back and leg pain scores improved from 6.8 and 5.9 to 2.7 and 2.7, respectively. Mean follow-up was 32.1 months. For ODI, 64.3% of patients achieved MCID. For VAS back and leg pain, 82.9% and 72.2%, respectively, reached MCID. CONCLUSIONS: MCID represents the threshold at which patients feel a meaningful clinical improvement has occurred. Our study results suggest that the majority of elderly patients with modest ASD can achieve MCID with MIS.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2016

Volume

86

Start / End Page

168 / 172

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Curvatures
  • Sacrum
  • Recovery of Function
  • Radiography
  • Minimally Invasive Surgical Procedures
  • Male
  • Lumbar Vertebrae
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Park, P., Okonkwo, D. O., Nguyen, S., Mundis, G. M., Than, K. D., Deviren, V., … International Spine Study Group, . (2016). Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery? World Neurosurg, 86, 168–172. https://doi.org/10.1016/j.wneu.2015.09.072
Park, Paul, David O. Okonkwo, Stacie Nguyen, Gregory M. Mundis, Khoi D. Than, Vedat Deviren, Frank La Marca, et al. “Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery?World Neurosurg 86 (February 2016): 168–72. https://doi.org/10.1016/j.wneu.2015.09.072.
Park P, Okonkwo DO, Nguyen S, Mundis GM, Than KD, Deviren V, et al. Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery? World Neurosurg. 2016 Feb;86:168–72.
Park, Paul, et al. “Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery?World Neurosurg, vol. 86, Feb. 2016, pp. 168–72. Pubmed, doi:10.1016/j.wneu.2015.09.072.
Park P, Okonkwo DO, Nguyen S, Mundis GM, Than KD, Deviren V, La Marca F, Fu K-M, Wang MY, Uribe JS, Anand N, Fessler R, Nunley PD, Chou D, Kanter AS, Shaffrey CI, Akbarnia BA, Passias PG, Eastlack RK, Mummaneni PV, International Spine Study Group. Can a Minimal Clinically Important Difference Be Achieved in Elderly Patients with Adult Spinal Deformity Who Undergo Minimally Invasive Spinal Surgery? World Neurosurg. 2016 Feb;86:168–172.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2016

Volume

86

Start / End Page

168 / 172

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Curvatures
  • Sacrum
  • Recovery of Function
  • Radiography
  • Minimally Invasive Surgical Procedures
  • Male
  • Lumbar Vertebrae
  • Humans