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

Autor: Hayashi K; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France. kh_ocg@yahoo.co.jp.; Department of Orthopedic Surgery, Osaka City Juso Hospital, 2-12-27 Nonakakita, Yodogawa-ku, Osaka, 532-0034, Japan. kh_ocg@yahoo.co.jp.; Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. kh_ocg@yahoo.co.jp., Boissière L; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France.; ELSAN, Polyclinique Jean Villar, Bruges Cedex, France., Larrieu D; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France., Bourghli A; Orthopedic and Spinal Surgery Department, Kingdom Hospital, Riyadh, Saudi Arabia., Gille O; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France., Vital JM; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France., Guevara-Villazón F; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France., Pellisé F; Spine Surgery Unit, Vall D'Hebron Hospital, Barcelona, Spain., Pérez-Grueso FJS; Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain., Kleinstück F; Spine Center, Schulthess Klinik, Zürich, Switzerland., Acaroglu E; Ankara Spine Center, Ankara, Turkey., Alanay A; Comprehensive Spine Center, Acibadem Maslak Hospital, Istanbul, Turkey., Nakamura H; Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan., Obeid I; Spine Surgery Unit, Bordeaux University Pellegrin Hospital, Bordeaux, France.; ELSAN, Polyclinique Jean Villar, Bruges Cedex, France.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2020 Dec; Vol. 29 (12), pp. 3051-3062. Date of Electronic Publication: 2020 Oct 01.
DOI: 10.1007/s00586-020-06611-4
Abstrakt: Purpose: 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.
Methods: 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.
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.
Conclusions: 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.
Databáze: MEDLINE
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