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Do adult spinal deformity patients who achieve and maintain PI-LL < 10 have better patient-reported and clinical outcomes compared to patients with PI-LL ≥ 10? A propensity score-matched analysis - Lumbar Fusion

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This article investigated whether patients with spinopelvic mismatch report worse outcomes compared to those who achieve proper alignment after spinal deformity surgery. The study included 164 patients who underwent posterior spinal fusion due to deformity. The key outcomes measured were patient-reported outcomes (PROs) using the Scoliosis Research Society-22r and Oswestry Disability Index scales, as well as reoperation rates at 1- and 2-year follow-ups. The results showed that patients who achieved and maintained proper alignment had similar PROs and reoperation rates compared to those with spinopelvic mismatch. This suggests that achieving proper alignment can lead to favorable outcomes in terms of patient-reported outcomes and reoperations. PMID: 37819577 | DOI: 10.1007/s43390-023-00766-y

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: Patients who achieve and maintain PI-LL < 10 2-years postop following adult spinal deformity surgery have nearly identical SRS-22r and ODI outcomes, and comparable 2-year reoperation rates as compared to patients who have PI-LL ≥ 10. Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine Deform. 2023 Oct 11. doi: 10.1007/s43390-023-00766-y. Online ahead of print.ABSTRACTPURPOSE: To investigate whether patients with spinopelvic mismatch (PI-LL ≥ 10) report worse patient-reported outcomes (PROs) compared to patients who achieve PI-LL < 10 at 2-year postop.METHODS: In this retrospective study, propensity score matching (PSM) was used to analyze patients who underwent posterior spinal fusion,

Spine Deform. 2023 Oct 11. doi: 10.1007/s43390-023-00766-y. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether patients with spinopelvic mismatch (PI-LL ≥ 10) report worse patient-reported outcomes (PROs) compared to patients who achieve PI-LL < 10 at 2-year postop.

METHODS: In this retrospective study, propensity score matching (PSM) was used to analyze patients who underwent posterior spinal fusion due to deformity, as defined by one or more of the following criteria: PI-LL ≥ 25°, T1 pelvic angle ≥ 30°, sagittal vertical axis ≥ 15 cm, thoracic scoliosis ≥ 70°, thoracolumbar scoliosis ≥ 50°, coronal malalignment ≥ 7 cm, or those who underwent a three-column osteotomy or fusion with ≥ 12 levels. Key outcomes were total Scoliosis Research Society-22r, Oswestry Disability Index (PROs), and reoperation at 1- and 2-year postop. Patients were dichotomized based on their 2-year alignment: PI-LL ≥ 10° and PI-LL < 10°. A multivariable logistic regression model identified factors associated with achieving PI-LL < 10°, and independent predictors were matched using propensity score matching. Binary outcomes within matched cohorts were analyzed using the McNemar test, while continuous outcomes were analyzed using the Wilcoxon rank-sum test.

RESULTS: One hundred sixty-four patients with 2-year follow-up were included; mean age was 50.5 (standard error mean (SEM): 1.4) years, body mass index was 24.1(SEM 1.0), and number of operative levels was 13.5 (SEM 0.3). 84 (51.2%) and 80 (48.8%) patients achieved PI-LL < 10 and PI-LL ≥ 10 at 2-year follow-up, respectively. Baseline pelvic incidence [odds ratio (OR): 0.96 (95% CI 0.92-0.99)] and baseline PI-LL [OR: 0.95 (95% CI 0.9-0.99)] were independent predictors of achieving PI-LL < 10 at 2 years. When comparing propensity matched pairs, no significant differences were found in baseline PROs. At both 1- and 2-year follow-up, outcomes on the SRS-22r scale were nearly identical for both groups (function [4.1(0.1) vs 4.0 (0.1), P = 0.75] ,Pain [3.9 (0.2) vs 3.9 (0.2), P = 0.86]appearance [4.2 (0.2) vs 3.8 (0.2), P = 0.08]mental health [4.1 (0.2) vs 4.1 (0.1), P = 0.96]satisfaction [4.4 (0.2) vs 4.4 (0.2), P = 0.72]and total [90.2 (2.5) vs 88.1 (2.5), P = 0.57]). Additionally, ODI scores at 2 years were comparable [18.1 (2.9) vs 22.4 (2.9), P = 0.30]. The 90-day reoperation rate was 2.6% (one patient) in both matched cohorts (P > 0.99). There was no significant difference in 1-year (P > 0.9999) or 2-year (P = 0.2207) reoperation rates between the groups.

: Patients who achieve and maintain PI-LL < 10 2-years postop following adult spinal deformity surgery have nearly identical SRS-22r and ODI outcomes, and comparable 2-year reoperation rates as compared to patients who have PI-LL ≥ 10.

PMID:37819577 | DOI:10.1007/s43390-023-00766-y

The London Spine Unit : best recognised day surgery hospital in the world

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Do adult spinal deformity patients who achieve and maintain PI-LL < 10 have better patient-reported and clinical outcomes compared to patients with PI-LL ≥ 10? A propensity score-matched analysis

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Spine Deform. 2023 Oct 11. doi: 10.1007/s43390-023-00766-y. Online ahead of print.ABSTRACTPURPOSE: To investigate whether patients with spinopelvic mismatch (PI-LL ≥ 10) report worse patient-reported outcomes (PROs) compared to patients who achieve PI-LL < 10 at 2-year postop.METHODS: In this retrospective study, propensity score matching (PSM) was used to analyze patients who underwent posterior spinal fusion

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