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Deterioration of Radiographic and Clinical Outcomes With Primary Treatment Adult Spinal Deformity Surgeries From Two Years to Three to Five Years Follow‐up: Paper #23

Bridwell, Keith H. MD (Washington University School of Medicine); Baldus, Christine R. RN, MHS; Berven, Sigurd MD; Edwards, Charles C. MD; Glassman, Steven D. MD; Hamill, Christopher L. MD; Horton, William C. MD; Ondra, Stephen L. MD; Schwab, Frank J. MD; Shaffrey, Christopher I. MD; Spinal Deformity Study Group

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Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 68–69
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Introduction: Most analyses of primary presentation adult spinal deformity surgery assess 2‐year follow‐up (f/u). However, many events occur between the 2‐year and 5‐year points. Our hypothesis is that between 2‐year and 3–5‐year points patients will show significant reduction in outcomes by Scoliosis Research Society (SRS) and Oswestry Disability Index (ODI) and will show increasing thoracic kyphosis, loss of lumbar lordosis and loss of coronal and sagittal balance.

Methods: The cohort is 133 patients entered into a multicenter database with complete preop, 2‐year and 3–5‐year data. All patients had adult spinal deformity and surgical treatment represented their first surgical reconstruction. Diagnoses: 82.5% scoliosis, 10% kyphosis and 7.5% miscellaneous. Outcome measures and basic radiographic parameters (curve size, thoracic and lumbar sagittal plane, coronal and sagittal balance) were assessed at those 3 time intervals.

Results: The major curve (preop 55°, 2‐year 29°, 3–5 year 23°), thoracic kyphosis T5 to T12 (32°, 32°, 32°) and lumbar lordosis T12 to sacrum (48°, 49°, 51°) did not change from the 2‐year to ultimate f/u. Likewise, coronal and sagittal balance parameters were the same at 2‐year and ultimate f/u. SRS total scores and modified ODI were identical at the 2‐year and final f/u (SRS 3.89 to 3.90; ODI 19.5 to 18.82). Preop SRS total score was 3.08. Patterns were the same for patients aged 18 to 40, 41 to 60 and 61 and over.

Conclusion: Contrary to our hypothesis, we could not establish deterioration in radiographic or clinical outcomes between the 2‐year and 3–5‐year f/u points.

Significance: One should not anticipate a radiographic and clinical deterioration of the outcomes of surgically treated primary presentation adult spinal deformity patients in this studied time interval.

© 2009 Lippincott Williams & Wilkins, Inc.