TY - JOUR
T1 - Correlation of 2-year SRS-22r and ODI patient-reported outcomes with 5-year patient-reported outcomes after complex spinal fusion
T2 - A 5-year single-institution study of 118 patients
AU - Adogwa, Owoicho
AU - Karikari, Isaac O.
AU - Elsamadicy, Aladine A.
AU - Sergesketter, Amanda R.
AU - Galan, Diego
AU - Bridwell, Keith H.
N1 - Publisher Copyright:
©AANS 2018, except where prohibited by US copyright law
PY - 2018/10
Y1 - 2018/10
N2 - OBJECTIVE Patient-reported outcomes (PROs) are often measured up to 2 years after surgery; however, prospective collection of longitudinal outcomes for 5 years postoperatively can be challenging due to lack of patient follow-up. The aim of this study was to determine whether PROs collected at 2-year follow-up accurately predict long-term PROs 5 years after complex spinal fusion (≥ 5 levels). METHODS This was an ambispective study of 118 adult patients (≥ 18 years old) undergoing ≥ 5-level spinal arthrodesis to the sacrum with iliac fixation from January 2002 to December 2011. Patient demographics and radiographic parameters as well as intraoperative variables were collected. PRO instruments (Scoliosis Research Society [SRS]-22r function, self-image, mental health, pain, and Oswestry Disability Index [ODI]) were completed before surgery then at 2 and 5 years after surgery. Primary outcome investigated in this study was the correlation between SRS-22r domains and ODI collected at 2- and 5-year follow-up. RESULTS Of the 118 patients, 111 patients had baseline PROs, 105 patients had 2-year follow-up data, and 91 patients had 5-year follow-up PRO data with 72% undergoing revision surgery. The average pre- and postoperative major coronal curve Cobb angles for the cohort were 32.1° ± 23.7° and 19.8° ± 19.3°, respectively. There was a strong correlation between 2- and 5-year ODI (r2 = 0.80, p < 0.001) and between 2- and 5-year SRS-22r domains, including function (r2 = 0.79, p < 0.001), self-image (r2 = 0.82, p < 0.001), mental health (r2 = 0.77, p < 0.001), and pain (r2 = 0.79, p < 0.001). Of the PROs, ODI showed the greatest absolute change from baseline to 2- and 5-year follow-up (2-year D 17.6 ± 15.9; 5-year D 16.5 ± 19.9) followed by SRS-22r self-image (2-year D 1.4 ± 0.96; 5-year D 1.3 ± 1.0), pain (2-year D 0.94 ± 0.97; 5-year D 0.80 ± 1.0), function (2-year D 0.60 ± 0.62; 5-year D 0.49 ± 0.79), and mental health (2-year D 0.49 ± 0.77; 5-year D 0.38 ± 0.84). CONCLUSIONS Patient-reported outcomes collected at 2-year follow-up may accurately predict long-term PROs (5-year follow-up).
AB - OBJECTIVE Patient-reported outcomes (PROs) are often measured up to 2 years after surgery; however, prospective collection of longitudinal outcomes for 5 years postoperatively can be challenging due to lack of patient follow-up. The aim of this study was to determine whether PROs collected at 2-year follow-up accurately predict long-term PROs 5 years after complex spinal fusion (≥ 5 levels). METHODS This was an ambispective study of 118 adult patients (≥ 18 years old) undergoing ≥ 5-level spinal arthrodesis to the sacrum with iliac fixation from January 2002 to December 2011. Patient demographics and radiographic parameters as well as intraoperative variables were collected. PRO instruments (Scoliosis Research Society [SRS]-22r function, self-image, mental health, pain, and Oswestry Disability Index [ODI]) were completed before surgery then at 2 and 5 years after surgery. Primary outcome investigated in this study was the correlation between SRS-22r domains and ODI collected at 2- and 5-year follow-up. RESULTS Of the 118 patients, 111 patients had baseline PROs, 105 patients had 2-year follow-up data, and 91 patients had 5-year follow-up PRO data with 72% undergoing revision surgery. The average pre- and postoperative major coronal curve Cobb angles for the cohort were 32.1° ± 23.7° and 19.8° ± 19.3°, respectively. There was a strong correlation between 2- and 5-year ODI (r2 = 0.80, p < 0.001) and between 2- and 5-year SRS-22r domains, including function (r2 = 0.79, p < 0.001), self-image (r2 = 0.82, p < 0.001), mental health (r2 = 0.77, p < 0.001), and pain (r2 = 0.79, p < 0.001). Of the PROs, ODI showed the greatest absolute change from baseline to 2- and 5-year follow-up (2-year D 17.6 ± 15.9; 5-year D 16.5 ± 19.9) followed by SRS-22r self-image (2-year D 1.4 ± 0.96; 5-year D 1.3 ± 1.0), pain (2-year D 0.94 ± 0.97; 5-year D 0.80 ± 1.0), function (2-year D 0.60 ± 0.62; 5-year D 0.49 ± 0.79), and mental health (2-year D 0.49 ± 0.77; 5-year D 0.38 ± 0.84). CONCLUSIONS Patient-reported outcomes collected at 2-year follow-up may accurately predict long-term PROs (5-year follow-up).
KW - Deformity correction
KW - Patient-reported outcomes
KW - SRS domains
KW - Surgical technique
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U2 - 10.3171/2018.2.SPINE171142
DO - 10.3171/2018.2.SPINE171142
M3 - Article
C2 - 29979138
AN - SCOPUS:85054787796
SN - 1547-5654
VL - 29
SP - 422
EP - 428
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 4
ER -