TY - JOUR
T1 - Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery
AU - on behalf of the ISSG
AU - Diebo, Bassel G.
AU - Alsoof, Daniel
AU - Lafage, Renaud
AU - Daher, Mohammad
AU - Balmaceno-Criss, Mariah
AU - Passias, Peter G.
AU - Ames, Christopher P.
AU - Shaffrey, Christopher I.
AU - Burton, Douglas C.
AU - Deviren, Vedat
AU - Line, Breton G.
AU - Soroceanu, Alex
AU - Hamilton, David Kojo
AU - Klineberg, Eric O.
AU - Mundis, Gregory M.
AU - Kim, Han Jo
AU - Gum, Jeffrey L.
AU - Smith, Justin S.
AU - Uribe, Juan S.
AU - Kebaish, Khaled M.
AU - Gupta, Munish C.
AU - Nunley, Pierce D.
AU - Eastlack, Robert K.
AU - Hostin, Richard
AU - Protopsaltis, Themistocles S.
AU - Lenke, Lawrence G.
AU - Hart, Robert A.
AU - Schwab, Frank J.
AU - Bess, Shay
AU - Lafage, Virginie
AU - Daniels, Alan H.
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/4
Y1 - 2024/4
N2 - Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence–lumbar lordosis (PI-LL), and surgical invasiveness score. Results: In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (−1.2 vs. −3.6°, p = 0.039) for a comparable PI-LL correction (−11.9 vs. −15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years. Conclusions: Patients with a self-reported loss of balance/unsteady gait have significantly worse PROMs and higher risk of PJK.
AB - Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence–lumbar lordosis (PI-LL), and surgical invasiveness score. Results: In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (−1.2 vs. −3.6°, p = 0.039) for a comparable PI-LL correction (−11.9 vs. −15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years. Conclusions: Patients with a self-reported loss of balance/unsteady gait have significantly worse PROMs and higher risk of PJK.
KW - adult spinal deformity
KW - balance
KW - radiological outcomes
UR - http://www.scopus.com/inward/record.url?scp=85192501531&partnerID=8YFLogxK
U2 - 10.3390/jcm13082202
DO - 10.3390/jcm13082202
M3 - Article
C2 - 38673475
AN - SCOPUS:85192501531
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 8
M1 - 2202
ER -