Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: A prospective multicenter analysis

Frank J. Schwab, Benjamin Blondel, Shay Bess, Richard Hostin, Christopher I. Shaffrey, Justin S. Smith, Oheneba Boachie-Adjei, Douglas C. Burton, Behrooz A. Akbarnia, Gregory M. Mundis, Christopher P. Ames, Khaled Kebaish, Robert Hart, Jean Pierre Farcy, Virginie Lafage

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Abstract

Objective. Evaluate correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with ASD. Summary of Background Data. Sagittal spinal deformity is commonly defined by an increased sagittal vertical axis (SVA); however, SVA alone may underestimate the severity of the deformity. Spinopelvic parameters provide a more complete assessment of the sagittal plane but only limited data are available that correlate spinopelvic parameters with disability. Methods. Baseline demographic, radiographical, and HRQOL data were obtained for all patients enrolled in a multicenter consecutive database. Inclusion criteria were: age more than 18 years and radiographical diagnosis of ASD. Radiographical evaluation was conducted on the frontal and lateral planes and HRQOL questionnaires (Oswestry Disability Index [ODI], Scoliosis Research Society-22r and Short Form [SF]-12) were completed. Radiographical parameters demonstrating highest correlation with HRQOL values were evaluated to determine thresholds predictive of ODI more than 40. Results. Four hundred ninety-two consecutive patients with ASD (mean age, 51.9 yr) were enrolled. Patients from the OP group (n = 178) were older (55 vs. 50.1 yr, P <0.05), had greater SVA (5.5 vs. 1.7 cm, P <0.05), greater pelvic tilt (PT; 22° vs. 11°, P <0.05), and greater pelvic incidence/lumbar lordosis PI/LL mismatch (PI-LL; 12.2 vs. 4.3; P <0.05) than NONOP group (n = 314). OP group demonstrated greater disability on all HRQOL measures compared with NONOP group (ODI = 41.4 vs. 23.9, P <0.05; Scoliosis Research Society score total = 2.9 vs. 3.5, P <0.05). Pearson analysis demonstrated that among all parameters, PT, SVA, and PILL correlated most strongly with disability for both OP and NONOP groups (P <0.001). Linear regression models demonstrated threshold radiographical spinopelvic parameters for ODI more than 40 to be: PT 22° or more (r = 0.38), SVA 47 mm or more (r = 0.47), PI - LL 11° or more (r = 0.45). Conclusion. ASD is a disabling condition. Prospective analysis of consecutively enrolled patients with ASD demonstrated that PT and PI-LL combined with SVA can predict patient disability and provide a guide for patient assessment for appropriate therapeutic decision making. Threshold values for severe disability (ODI > 40) included: PT 22° or more, SVA 47 mm or more, and PI - LL 11° or more.

Original languageEnglish (US)
JournalSpine
Volume38
Issue number13
DOIs
StatePublished - Jun 1 2013

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Demography
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Keywords

  • Adult spinal deformity
  • Conservative care
  • Disability
  • Health related quality of life
  • Patient assessment
  • Prediction
  • Prospective analysis
  • Radiographical parameters
  • Sagittal alignment
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity : A prospective multicenter analysis. / Schwab, Frank J.; Blondel, Benjamin; Bess, Shay; Hostin, Richard; Shaffrey, Christopher I.; Smith, Justin S.; Boachie-Adjei, Oheneba; Burton, Douglas C.; Akbarnia, Behrooz A.; Mundis, Gregory M.; Ames, Christopher P.; Kebaish, Khaled; Hart, Robert; Farcy, Jean Pierre; Lafage, Virginie.

In: Spine, Vol. 38, No. 13, 01.06.2013.

Research output: Contribution to journalArticle

Schwab, FJ, Blondel, B, Bess, S, Hostin, R, Shaffrey, CI, Smith, JS, Boachie-Adjei, O, Burton, DC, Akbarnia, BA, Mundis, GM, Ames, CP, Kebaish, K, Hart, R, Farcy, JP & Lafage, V 2013, 'Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: A prospective multicenter analysis', Spine, vol. 38, no. 13. https://doi.org/10.1097/BRS.0b013e318292b7b9
Schwab, Frank J. ; Blondel, Benjamin ; Bess, Shay ; Hostin, Richard ; Shaffrey, Christopher I. ; Smith, Justin S. ; Boachie-Adjei, Oheneba ; Burton, Douglas C. ; Akbarnia, Behrooz A. ; Mundis, Gregory M. ; Ames, Christopher P. ; Kebaish, Khaled ; Hart, Robert ; Farcy, Jean Pierre ; Lafage, Virginie. / Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity : A prospective multicenter analysis. In: Spine. 2013 ; Vol. 38, No. 13.
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abstract = "Objective. Evaluate correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with ASD. Summary of Background Data. Sagittal spinal deformity is commonly defined by an increased sagittal vertical axis (SVA); however, SVA alone may underestimate the severity of the deformity. Spinopelvic parameters provide a more complete assessment of the sagittal plane but only limited data are available that correlate spinopelvic parameters with disability. Methods. Baseline demographic, radiographical, and HRQOL data were obtained for all patients enrolled in a multicenter consecutive database. Inclusion criteria were: age more than 18 years and radiographical diagnosis of ASD. Radiographical evaluation was conducted on the frontal and lateral planes and HRQOL questionnaires (Oswestry Disability Index [ODI], Scoliosis Research Society-22r and Short Form [SF]-12) were completed. Radiographical parameters demonstrating highest correlation with HRQOL values were evaluated to determine thresholds predictive of ODI more than 40. Results. Four hundred ninety-two consecutive patients with ASD (mean age, 51.9 yr) were enrolled. Patients from the OP group (n = 178) were older (55 vs. 50.1 yr, P <0.05), had greater SVA (5.5 vs. 1.7 cm, P <0.05), greater pelvic tilt (PT; 22° vs. 11°, P <0.05), and greater pelvic incidence/lumbar lordosis PI/LL mismatch (PI-LL; 12.2 vs. 4.3; P <0.05) than NONOP group (n = 314). OP group demonstrated greater disability on all HRQOL measures compared with NONOP group (ODI = 41.4 vs. 23.9, P <0.05; Scoliosis Research Society score total = 2.9 vs. 3.5, P <0.05). Pearson analysis demonstrated that among all parameters, PT, SVA, and PILL correlated most strongly with disability for both OP and NONOP groups (P <0.001). Linear regression models demonstrated threshold radiographical spinopelvic parameters for ODI more than 40 to be: PT 22° or more (r = 0.38), SVA 47 mm or more (r = 0.47), PI - LL 11° or more (r = 0.45). Conclusion. ASD is a disabling condition. Prospective analysis of consecutively enrolled patients with ASD demonstrated that PT and PI-LL combined with SVA can predict patient disability and provide a guide for patient assessment for appropriate therapeutic decision making. Threshold values for severe disability (ODI > 40) included: PT 22° or more, SVA 47 mm or more, and PI - LL 11° or more.",
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TY - JOUR

T1 - Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity

T2 - A prospective multicenter analysis

AU - Schwab, Frank J.

AU - Blondel, Benjamin

AU - Bess, Shay

AU - Hostin, Richard

AU - Shaffrey, Christopher I.

AU - Smith, Justin S.

AU - Boachie-Adjei, Oheneba

AU - Burton, Douglas C.

AU - Akbarnia, Behrooz A.

AU - Mundis, Gregory M.

AU - Ames, Christopher P.

AU - Kebaish, Khaled

AU - Hart, Robert

AU - Farcy, Jean Pierre

AU - Lafage, Virginie

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Objective. Evaluate correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with ASD. Summary of Background Data. Sagittal spinal deformity is commonly defined by an increased sagittal vertical axis (SVA); however, SVA alone may underestimate the severity of the deformity. Spinopelvic parameters provide a more complete assessment of the sagittal plane but only limited data are available that correlate spinopelvic parameters with disability. Methods. Baseline demographic, radiographical, and HRQOL data were obtained for all patients enrolled in a multicenter consecutive database. Inclusion criteria were: age more than 18 years and radiographical diagnosis of ASD. Radiographical evaluation was conducted on the frontal and lateral planes and HRQOL questionnaires (Oswestry Disability Index [ODI], Scoliosis Research Society-22r and Short Form [SF]-12) were completed. Radiographical parameters demonstrating highest correlation with HRQOL values were evaluated to determine thresholds predictive of ODI more than 40. Results. Four hundred ninety-two consecutive patients with ASD (mean age, 51.9 yr) were enrolled. Patients from the OP group (n = 178) were older (55 vs. 50.1 yr, P <0.05), had greater SVA (5.5 vs. 1.7 cm, P <0.05), greater pelvic tilt (PT; 22° vs. 11°, P <0.05), and greater pelvic incidence/lumbar lordosis PI/LL mismatch (PI-LL; 12.2 vs. 4.3; P <0.05) than NONOP group (n = 314). OP group demonstrated greater disability on all HRQOL measures compared with NONOP group (ODI = 41.4 vs. 23.9, P <0.05; Scoliosis Research Society score total = 2.9 vs. 3.5, P <0.05). Pearson analysis demonstrated that among all parameters, PT, SVA, and PILL correlated most strongly with disability for both OP and NONOP groups (P <0.001). Linear regression models demonstrated threshold radiographical spinopelvic parameters for ODI more than 40 to be: PT 22° or more (r = 0.38), SVA 47 mm or more (r = 0.47), PI - LL 11° or more (r = 0.45). Conclusion. ASD is a disabling condition. Prospective analysis of consecutively enrolled patients with ASD demonstrated that PT and PI-LL combined with SVA can predict patient disability and provide a guide for patient assessment for appropriate therapeutic decision making. Threshold values for severe disability (ODI > 40) included: PT 22° or more, SVA 47 mm or more, and PI - LL 11° or more.

AB - Objective. Evaluate correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with ASD. Summary of Background Data. Sagittal spinal deformity is commonly defined by an increased sagittal vertical axis (SVA); however, SVA alone may underestimate the severity of the deformity. Spinopelvic parameters provide a more complete assessment of the sagittal plane but only limited data are available that correlate spinopelvic parameters with disability. Methods. Baseline demographic, radiographical, and HRQOL data were obtained for all patients enrolled in a multicenter consecutive database. Inclusion criteria were: age more than 18 years and radiographical diagnosis of ASD. Radiographical evaluation was conducted on the frontal and lateral planes and HRQOL questionnaires (Oswestry Disability Index [ODI], Scoliosis Research Society-22r and Short Form [SF]-12) were completed. Radiographical parameters demonstrating highest correlation with HRQOL values were evaluated to determine thresholds predictive of ODI more than 40. Results. Four hundred ninety-two consecutive patients with ASD (mean age, 51.9 yr) were enrolled. Patients from the OP group (n = 178) were older (55 vs. 50.1 yr, P <0.05), had greater SVA (5.5 vs. 1.7 cm, P <0.05), greater pelvic tilt (PT; 22° vs. 11°, P <0.05), and greater pelvic incidence/lumbar lordosis PI/LL mismatch (PI-LL; 12.2 vs. 4.3; P <0.05) than NONOP group (n = 314). OP group demonstrated greater disability on all HRQOL measures compared with NONOP group (ODI = 41.4 vs. 23.9, P <0.05; Scoliosis Research Society score total = 2.9 vs. 3.5, P <0.05). Pearson analysis demonstrated that among all parameters, PT, SVA, and PILL correlated most strongly with disability for both OP and NONOP groups (P <0.001). Linear regression models demonstrated threshold radiographical spinopelvic parameters for ODI more than 40 to be: PT 22° or more (r = 0.38), SVA 47 mm or more (r = 0.47), PI - LL 11° or more (r = 0.45). Conclusion. ASD is a disabling condition. Prospective analysis of consecutively enrolled patients with ASD demonstrated that PT and PI-LL combined with SVA can predict patient disability and provide a guide for patient assessment for appropriate therapeutic decision making. Threshold values for severe disability (ODI > 40) included: PT 22° or more, SVA 47 mm or more, and PI - LL 11° or more.

KW - Adult spinal deformity

KW - Conservative care

KW - Disability

KW - Health related quality of life

KW - Patient assessment

KW - Prediction

KW - Prospective analysis

KW - Radiographical parameters

KW - Sagittal alignment

KW - Surgery

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U2 - 10.1097/BRS.0b013e318292b7b9

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