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Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity.

Publication ,  Journal Article
Line, B; Bess, S; Lafage, V; Ames, C; Burton, D; Kim, HJ; Gupta, M; Hart, R; Klineberg, E; Kelly, M; Kebaish, K; Hostin, R; Mundis, G ...
Published in: Spine (Phila Pa 1976)
August 15, 2020

STUDY DESIGN: Retrospective analysis of a multicenter prospective adult spinal deformity (ASD) database. OBJECTIVE: Quantify postoperative improvements in pain, function, mental health, and self-image for different ASD types. SUMMARY OF BACKGROUND DATA: Medical providers are commonly requested to counsel patients on anticipated improvements in specific health domains including pain, function, and self-image following surgery. ASD is a heterogeneous condition; therefore, health domain improvements may vary according to deformity type. Few studies have quantified outcomes for specific ASD types. METHODS: Surgically treated ASD patients (≥4 levels fused) prospectively enrolled into a multicenter database, minimum 2-year follow-up, were categorized into ASD types according to Scoliosis Research Society-Schwab ASD classification (THORACIC, LUMBAR, DOUBLE, SAGITTAL, MIXED). Demographic, radiographic, operative, and patient reported outcome measures (NRS back and leg pain, SRS-22r, SF-36) data were evaluated. Preoperative and last postoperative values for pain, physical and social function, mental health, and self-image were evaluated, improvements in each domain were quantified, and domain scores compared to generational normative values. Postoperative improvements were also calculated for three age cohorts (<45 yr, 45-65 yr, and >65 yr) within each deformity type. RESULTS: 359 of 564 patients eligible for study (mean age 57.9 yr, mean scoliosis 43.4°, mean SVA 63.3 mm, mean 11.7 levels fused) had ≥2 yr follow-up. Domain improvements for the entire ASD population were 45.1% for back pain, 41.3% for leg pain, 27.1% for physical function, 35.9% for social function, 62.0% for self-image, and 22.6% for mental health (P < 0.05). LUMBAR, SAGITTAL, and MIXED had greatest improvements in pain and function, while THORACIC and DOUBLE had greatest improvements in self-image. Self-image was the most impacted preoperative domain and demonstrated the greatest postoperative improvement for all ASD types. CONCLUSION: ASD patients demonstrated quantifiable postoperative improvements in pain, self-image, physical and social function, and mental health; however, improvements differed between ASD types. Further research is needed to understand specific patient expectations for ASD treatment. LEVEL OF EVIDENCE: 3.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

August 15, 2020

Volume

45

Issue

16

Start / End Page

1118 / 1127

Location

United States

Related Subject Headings

  • Spine
  • Spinal Curvatures
  • Self Concept
  • Scoliosis
  • Retrospective Studies
  • Quality of Life
  • Prospective Studies
  • Postoperative Period
  • Orthopedics
  • Middle Aged
 

Citation

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Line, B., Bess, S., Lafage, V., Ames, C., Burton, D., Kim, H. J., … International Spine Study Group, . (2020). Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity. Spine (Phila Pa 1976), 45(16), 1118–1127. https://doi.org/10.1097/BRS.0000000000003473
Line, Breton, Shay Bess, Virginie Lafage, Christopher Ames, Douglas Burton, Han Jo Kim, Munish Gupta, et al. “Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity.Spine (Phila Pa 1976) 45, no. 16 (August 15, 2020): 1118–27. https://doi.org/10.1097/BRS.0000000000003473.
Line B, Bess S, Lafage V, Ames C, Burton D, Kim HJ, et al. Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity. Spine (Phila Pa 1976). 2020 Aug 15;45(16):1118–27.
Line, Breton, et al. “Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity.Spine (Phila Pa 1976), vol. 45, no. 16, Aug. 2020, pp. 1118–27. Pubmed, doi:10.1097/BRS.0000000000003473.
Line B, Bess S, Lafage V, Ames C, Burton D, Kim HJ, Gupta M, Hart R, Klineberg E, Kelly M, Kebaish K, Hostin R, Mundis G, Schwab F, Shaffrey C, Smith JS, International Spine Study Group. Counseling Guidelines for Anticipated Postsurgical Improvements in Pain, Function, Mental Health, and Self-image for Different Types of Adult Spinal Deformity. Spine (Phila Pa 1976). 2020 Aug 15;45(16):1118–1127.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

August 15, 2020

Volume

45

Issue

16

Start / End Page

1118 / 1127

Location

United States

Related Subject Headings

  • Spine
  • Spinal Curvatures
  • Self Concept
  • Scoliosis
  • Retrospective Studies
  • Quality of Life
  • Prospective Studies
  • Postoperative Period
  • Orthopedics
  • Middle Aged