Improvement in SRS-22R Self-Image Correlate Most with Patient Satisfaction after 3-Column Osteotomy

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Abstract

Study Design.Longitudinal cohort.Objectives.The aim of this study was to examine the relationship between patient satisfaction, patient-reported outcome measures (PROMs) and radiographic parameters in adult spine deformity (ASD) patients undergoing three-column osteotomies (3CO).Summary of Background Data.Identifying factors that influence patient satisfaction in ASD is important. Evidence suggests Scoliosis Research Society-22R (SRS-22R) Self-Image domain correlates with patient satisfaction in patients with ASD.Methods.This is a retrospective review of ASD patients enrolled in a prospective, multicenter database undergoing a 3CO with complete SRS-22R pre-op and minimum 2-years postop. Spearman correlations were used to evaluate associations between the 2-year SRS Satisfaction score and changes in SRS-22R domain scores, Oswestry Disability Index (ODI), and radiographic parameters.Results.Of 135 patients eligible for 2-year follow-up, 98 patients (73%) had complete pre-and 2-year postop data. The cohort was mostly female (69%) with mean BMI of 29.7kg/m2and age of 61.0 years. Mean levels fused was 12.9 with estimated blood loss of 2695 cc and OR time of 407 minutes; 27% were revision surgeries. There was a statistically significant improvement between pre-and 2-year post-op PROMs and all radiographic parameters except Coronal Vertical Axis. The majority of patients had an SRS Satisfaction score of ≥3.0 (90%) or ≥4.0 (68%), consistent with a moderate ceiling effect. Correlations of patient satisfaction was significant for Pain (0.43, P<0.001), Activity (0.39, P<0.001), Mental (0.38, P=0.001) Self-Image (0.52, P<0.001). ODI and Short-Form-36 Physical component summary had a moderate correlation as well, with mental component summary being weak. There was no statistically significant correlation between any radiographic or operative parameters and patient satisfaction.Conclusion.There was statistically significant improvement in all PROMs and radiographic parameters, except coronal vertical axis at 2 years in ASD patients undergoing 3CO. Improvement in SRS Self-Image domain has the strongest correlation with patient satisfaction.Level of Evidence:.

Original languageEnglish
Pages (from-to)822-827
Number of pages6
JournalSpine
Volume46
Issue number12
DOIs
StatePublished - Jun 15 2021

Keywords

  • 3-column osteotomy
  • Oswestry Disability Index
  • SRS-22R
  • adult spine deformity
  • coronal vertical axis
  • patient reported outcome measures
  • pedicle subtraction osteotomy
  • radiographic parameters
  • self-image
  • vertebral column resection

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