TY - JOUR
T1 - Reaching minimal clinically important difference in adult spinal deformity surgery
T2 - A comparison of patients from North America and Japan
AU - Arima, Hideyuki
AU - Glassman, Steven D.
AU - Bridwell, Keith
AU - Yamato, Yu
AU - Yagi, Mitsuru
AU - Watanabe, Kota
AU - Matsumoto, Morio
AU - Inami, Satoshi
AU - Taneichi, Hiroshi
AU - Matsuyama, Yukihiro
AU - Carreon, Leah Y.
N1 - Funding Information:
Funds were received from the National Institute of Arthritis and Musculoskeletal and Skin Diseases in support of this work (grant no. 5R01AR055176-03). We would like to acknowledge Christopher Shaffrey, MD, Oheneba Boachie-Adjei, MD, Stefan Parent, MD, Stephen Lewis, MD, Tyler Koski, MD, Charles Edwards II, MD, Frank Schwab, MD, Jacob Buchowski, MD, Charles H. Crawford III, MD, Han Jo Kim, MD, Lawrence G. Lenke, MD, and Justin Smith, MD, for contributing patients to the study.
Publisher Copyright:
© AANS 2020, except where prohibited by US copyright law.
PY - 2020/6
Y1 - 2020/6
N2 - OBJECTIVE The Scoliosis Research Society-22r questionnaire (SRS-22r) has been shown to be reliable, valid, and responsive to change in patients with adult spinal deformity (ASD) undergoing surgery. The minimal clinically important difference (MCID) is the smallest difference in a health-related quality of life score that is considered to be worthwhile or clinically important to the individual. The authors hypothesized that the proportion of patients with ASD achieving an MCID in the SRS-22r score would be different between two culturally different cohorts. The purpose of this study was to compare the proportion of patients with ASD achieving MCID for the SRS-22r domains in North American (NA) and Japanese cohorts. METHODS A total of 137 patients from North America (123 women, mean age 60.0 years) and 60 patients from Japan (56 women, mean age 65.5 years) with at least 2 years of follow-up after corrective spine surgery for ASD were included. Except for self-image, published Japanese MCID values of SRS-22r for ASD were higher (function = 0.90, pain = 0.85, self-image = 1.05, subtotal = 1.05) than the published NA MCID values (function = 0.60, pain = 0.40, self-image = 1.23, subtotal = 0.43). RESULTS There was a statistically significant improvement in all SRS-22r domain scores at 2 years compared to baseline in both cohorts. Except for mental health (NA = 0.32, Japanese = 0.72, p = 0.005), the mean improvement from baseline to 2 years was similar between the NA and Japanese cohorts. The proportion of patients achieving MCID was higher in North America for function (NA = 51%, Japanese = 30%, p = 0.006), pain (NA = 80%, Japanese = 47%, p < 0.001), and subtotal (NA = 72%, Japanese = 35%, p < 0.001), while there was no significant difference for self-image (NA = 53%, Japanese = 58%, p = 0.454). CONCLUSIONS Despite similar improvements in SRS-22r domain scores from baseline to 2 years postoperatively, the proportion of patients reaching SRS-22r MCID for function, pain, and subtotal after ASD surgery was higher in the NA cohort than in the Japanese cohort. This may imply that patients in North America and Japan may value observed changes in clinical status differently.
AB - OBJECTIVE The Scoliosis Research Society-22r questionnaire (SRS-22r) has been shown to be reliable, valid, and responsive to change in patients with adult spinal deformity (ASD) undergoing surgery. The minimal clinically important difference (MCID) is the smallest difference in a health-related quality of life score that is considered to be worthwhile or clinically important to the individual. The authors hypothesized that the proportion of patients with ASD achieving an MCID in the SRS-22r score would be different between two culturally different cohorts. The purpose of this study was to compare the proportion of patients with ASD achieving MCID for the SRS-22r domains in North American (NA) and Japanese cohorts. METHODS A total of 137 patients from North America (123 women, mean age 60.0 years) and 60 patients from Japan (56 women, mean age 65.5 years) with at least 2 years of follow-up after corrective spine surgery for ASD were included. Except for self-image, published Japanese MCID values of SRS-22r for ASD were higher (function = 0.90, pain = 0.85, self-image = 1.05, subtotal = 1.05) than the published NA MCID values (function = 0.60, pain = 0.40, self-image = 1.23, subtotal = 0.43). RESULTS There was a statistically significant improvement in all SRS-22r domain scores at 2 years compared to baseline in both cohorts. Except for mental health (NA = 0.32, Japanese = 0.72, p = 0.005), the mean improvement from baseline to 2 years was similar between the NA and Japanese cohorts. The proportion of patients achieving MCID was higher in North America for function (NA = 51%, Japanese = 30%, p = 0.006), pain (NA = 80%, Japanese = 47%, p < 0.001), and subtotal (NA = 72%, Japanese = 35%, p < 0.001), while there was no significant difference for self-image (NA = 53%, Japanese = 58%, p = 0.454). CONCLUSIONS Despite similar improvements in SRS-22r domain scores from baseline to 2 years postoperatively, the proportion of patients reaching SRS-22r MCID for function, pain, and subtotal after ASD surgery was higher in the NA cohort than in the Japanese cohort. This may imply that patients in North America and Japan may value observed changes in clinical status differently.
KW - Adult scoliosis
KW - Adult spinal deformity
KW - Cultural difference
KW - Minimum clinically important difference
KW - Scoliosis Research Society-22r
UR - http://www.scopus.com/inward/record.url?scp=85086383484&partnerID=8YFLogxK
U2 - 10.3171/2019.12.SPINE19593
DO - 10.3171/2019.12.SPINE19593
M3 - Article
C2 - 32005027
AN - SCOPUS:85086383484
SN - 1547-5654
VL - 32
SP - 859
EP - 864
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 6
ER -