Prediction of satisfaction after correction surgery for adult spinal deformity: differences between younger and older patients

European spine journal

article

Kazunori Hayashi¹  Louis Boissière¹  Daniel Larrieu¹  Anouar Bourghli⁵  Olivier Gille¹  Jean-Marc Vital¹  Fernando Guevara-Villazón¹  Ferran Pellisé⁶  Francisco Javier Sánchez Pérez-Grueso⁷  Frank Kleinstück⁸  Emre Acaroglu⁹  Ahmet Alanay^1,10  Hiroaki Nakamura³  Ibrahim Obeid¹ 

[1] Spine Surgery Unit, Bordeaux University Pellegrin Hospital;Department of Orthopedic Surgery, Osaka City Juso Hospital;Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine;Polyclinique Jean Villar;Orthopedic and Spinal Surgery Department, Kingdom Hospital;Spine Surgery Unit, Vall D’Hebron Hospital;Spine Surgery Unit, Hospital Universitario La Paz;Spine Center;Ankara Spine Center;Comprehensive Spine Center, Acibadem Maslak Hospital

关键词: Adult spinal deformity;    Patient satisfaction;    Appearance;    Propensity score;    Sagittal alignment;   

DOI  :  10.1007/s00586-020-06611-4

来源: Springer

【 摘 要 】

Achieving an adequate level of patient’s satisfaction with results is one of the goals of adult spinal deformity (ASD) surgery. However, it is unclear whether the same factors affect satisfaction in all patient populations. Patients’ age influences the postoperative course and prevalence of complications after ASD surgery. The purpose of this study was to determine the factors predicting satisfaction 2 years after ASD surgery in younger and older patients. A total of 119 patients under 40 years old, 155 patients 40 to 65 years old, and 148 patients over 65 years old at surgery who were followed for a minimum of 2 years after surgery were included. Multivariate analysis was used to determine independent related factors with maximum AUC for satisfaction 2 years after surgery in each group. A propensity-matched cohort under equivalent demographic and clinical characteristics was used to confirm the results. Logistic regression analyses revealed satisfaction among the under-40 group corresponded to prior spine surgery, complications, and self-image. That among the 40-to-65 group corresponded to neurologic complication, revision surgery, pain, and sagittal vertical axis restoration. Among the over-65 group satisfaction correlated with revision surgery, standing ability, and lumbar lordosis index restoration. Propensity score matching confirmed that sagittal alignment correction led to substantial satisfaction. In younger patients, avoiding complications and improving patients’ self-image were essential for substantial satisfaction levels. In older patients, revision, standing ability, as well as sagittal spinopelvic alignment restoration, were the key factors. Surgeons should consider the differences in goals of each patient.

【 授权许可】

Unknown