TY - JOUR
T1 - The health impact of adult cervical deformity in patients presenting for surgical treatment
T2 - Comparison to United States population norms and chronic disease states based on the EuroQuol-5 dimensions questionnaire
AU - Smith, Justin S.
AU - Line, Breton
AU - Bess, Shay
AU - Shaffrey, Christopher I.
AU - Kim, Han Jo
AU - Mundis, Gregory
AU - Scheer, Justin K.
AU - Klineberg, Eric
AU - O'Brien, Michael
AU - Hostin, Richard
AU - Gupta, Munish
AU - Daniels, Alan
AU - Kelly, Michael
AU - Gum, Jeffrey L.
AU - Schwab, Frank J.
AU - Lafage, Virginie
AU - Lafage, Renaud
AU - Ailon, Tamir
AU - Passias, Peter
AU - Protopsaltis, Themistocles
AU - Albert, Todd J.
AU - Riew, K. Daniel
AU - Hart, Robert
AU - Burton, Doug
AU - Deviren, Vedat
AU - Ames, Christopher P.
AU - Park, Paul
N1 - Publisher Copyright:
© Copyright 2017 by the Congress of Neurological Surgeons.
PY - 2017/5
Y1 - 2017/5
N2 - BACKGROUND: Although adult cervical spine deformity (ACSD) is associated with pain and disability, its health impact has not been quantified in comparison to other chronic diseases. OBJECTIVE: To perform a comparative analysis of the health impact of symptomatic ACSD to US normative and chronic disease values using EQ-5D (EuroQuol-5 Dimensions questionnaire) scores. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Baseline demographics and EQ-5D scores were collected and compared with US normative and disease state values. RESULTS: Of 121 ACSD patients, 115 (95%) completed the EQ-5D (60% women, mean age 61 years, previous spine surgery in 44%). Diagnoses included kyphosis with mid-cervical (63.4%), cervico-thoracic (23.5%), or thoracic (8.7%) apex and primary coronal deformity (4.3%). The mean ACSD EQ-5D index was 0.511 (standard definition = 0.224), which is 34% below the bottom 25th percentile (0.780) for similar age- and gender-matched US normative populations. Mean ACSD EQ-5D index values were worse than the bottom 25th percentile for several other disease states, including chronic ischemic heart disease (0.708), malignant breast cancer (0.708), and malignant prostate cancer (0.708). ACSD mean index values were comparable to the bottom 25th percentile values for blindness/low vision (0.543), emphysema (0.508), renal failure (0.506), and stroke (0.463). EQ-5D scores did not significantly differ based on cervical deformity type (P =.66). CONCLUSION: The health impact of symptomatic ACSD is substantial, with negative impact across all EQ-5D domains. The mean ACSD EQ-5D index was comparable to the bottom 25th percentile values for blindness/low vision, emphysema, renal failure, and stroke.
AB - BACKGROUND: Although adult cervical spine deformity (ACSD) is associated with pain and disability, its health impact has not been quantified in comparison to other chronic diseases. OBJECTIVE: To perform a comparative analysis of the health impact of symptomatic ACSD to US normative and chronic disease values using EQ-5D (EuroQuol-5 Dimensions questionnaire) scores. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Baseline demographics and EQ-5D scores were collected and compared with US normative and disease state values. RESULTS: Of 121 ACSD patients, 115 (95%) completed the EQ-5D (60% women, mean age 61 years, previous spine surgery in 44%). Diagnoses included kyphosis with mid-cervical (63.4%), cervico-thoracic (23.5%), or thoracic (8.7%) apex and primary coronal deformity (4.3%). The mean ACSD EQ-5D index was 0.511 (standard definition = 0.224), which is 34% below the bottom 25th percentile (0.780) for similar age- and gender-matched US normative populations. Mean ACSD EQ-5D index values were worse than the bottom 25th percentile for several other disease states, including chronic ischemic heart disease (0.708), malignant breast cancer (0.708), and malignant prostate cancer (0.708). ACSD mean index values were comparable to the bottom 25th percentile values for blindness/low vision (0.543), emphysema (0.508), renal failure (0.506), and stroke (0.463). EQ-5D scores did not significantly differ based on cervical deformity type (P =.66). CONCLUSION: The health impact of symptomatic ACSD is substantial, with negative impact across all EQ-5D domains. The mean ACSD EQ-5D index was comparable to the bottom 25th percentile values for blindness/low vision, emphysema, renal failure, and stroke.
KW - Adult
KW - Cervical deformity
KW - Cervical kyphosis
KW - Disability
KW - EQ-5D
KW - EQ-5D-3L
KW - Health impact
KW - Spine
UR - http://www.scopus.com/inward/record.url?scp=85034982738&partnerID=8YFLogxK
U2 - 10.1093/neuros/nyx028
DO - 10.1093/neuros/nyx028
M3 - Article
C2 - 28368524
AN - SCOPUS:85034982738
SN - 0148-396X
VL - 80
SP - 716
EP - 725
JO - Clinical Neurosurgery
JF - Clinical Neurosurgery
IS - 5
ER -