Open AccessPrediction of Health Status Based on Postoperative Radiographic Variables in Adult Scoliosis
Author(s) -
Zou Haibo,
Wu Chunhui,
Mehbod Amir A.,
Lick Corky,
Transfeldt Ensor E.
Publication year - 2014
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12116
Subject(s) - pelvic tilt , medicine , coronal plane , oswestry disability index , sagittal plane , scoliosis , radiography , cobb angle , lordosis , orthodontics , balance (ability) , lumbar , surgery , physical therapy , anatomy , low back pain , alternative medicine , pathology
Objective To evaluate the effect of surgical treatment on health related quality of life ( HRQOL ) and radiographic variables in patients with adult scoliosis. Methods Sixty‐eight patients with adult spinal deformities underwent radiographic analysis. The enrollment criteria were as follows: age older than 18 years, adult degenerative or progressive idiopathic scoliosis (Cobb angle >10°), and surgical treatment within one year before this study was undertaken. The following variables were measured: curve type, apical level, curve magnitude, coronal and sagittal balance using a C 7 plumb line ( C 7 PL ) and gravity line, lateral intervertebral olisthesis, lumbar lordosis, sacral slope and pelvic tilt. HRQOL was assessed by the Oswestry Disability Index ( ODI ). Both preoperative and postoperative data were collected and changes in radiographically assessed variables and ODI scores attributable to surgery calculated; correlations between these changes were then assessed. The radiographically assessed variables and ODI scores were analyzed with SigmaStat (SPSS, Chicago, IL, USA). The level of statistical significance was set at P < 0.05. Results Surgical treatment resulted in improvements in ODI scores and several radiographically assessed variables, including sagittal balance, lumbar lordosis, lateral olisthesis and coronal Cobb angle. Only sagittal balance expressed as C 7 PL was correlated to both preoperative and postoperative ODI . Gravity line, an alternative measurement of spinal balance, did not provide better correlations with HRQOL than C 7 PL . Conclusions Spinal balance assessed by gravity line did not provide a better correlation with HRQOL than C 7 PL . Loss of sacral slope and retroverted pelvis are commonly seen in adult scoliosis and are not significantly changed by surgical treatment, including restoration of lumbar lordosis and sagittal balance.