Outcomes of Operative Treatment for Adult Cervical Deformity: A Prospective Multicenter Assessment with 1-Year Follow-up

Tamir Ailon, Justin S. Smith, Christopher I. Shaffrey, Han Jo Kim, Gregory Mundis, Munish Gupta, Eric Klineberg, Frank Schwab, Virginie Lafage, Renaud Lafage, Peter Passias, Themistocles Protopsaltis, Brian Neuman, Alan Daniels, Justin K. Scheer, Alex Soroceanu, Robert Hart, Rick Hostin, Douglas Burton, Vedat DevirenTodd J. Albert, K. Daniel Riew, Shay Bess, Christopher P. Ames

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients. OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL. METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed. RESULTS: Of 77 ACD patients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomywas performed in 24%of patients.One year following surgery,ACDpatients had significant improvement in Neck Disability Index (50.5 to 38.0, P<.001), neck pain numeric rating scale score (6.9 to 4.3, P<.001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P< .001), and EQ-5D subscores: mobility (1.9 to 1.7, P=.019), usual activities (2.2 to 1.9, P=.007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014). CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.

Original languageEnglish (US)
Pages (from-to)1031-1039
Number of pages9
JournalClinical neurosurgery
Volume83
Issue number5
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

Keywords

  • Cervical deformity
  • Outcomes
  • Quality of life
  • Spinal deformity
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Ailon, T., Smith, J. S., Shaffrey, C. I., Kim, H. J., Mundis, G., Gupta, M., Klineberg, E., Schwab, F., Lafage, V., Lafage, R., Passias, P., Protopsaltis, T., Neuman, B., Daniels, A., Scheer, J. K., Soroceanu, A., Hart, R., Hostin, R., Burton, D., ... Ames, C. P. (2018). Outcomes of Operative Treatment for Adult Cervical Deformity: A Prospective Multicenter Assessment with 1-Year Follow-up. Clinical neurosurgery, 83(5), 1031-1039. https://doi.org/10.1093/neuros/nyx574