Younger Patients Are Differentially Affected by Stiffness-Related Disability Following Adult Spinal Deformity Surgery

International Spine Study Group

Research output: Contribution to journalArticle

Abstract

Objective: The Lumbar Stiffness Disability Index (LSDI) assesses impact of lumbar stiffness on activities of daily living. We hypothesized that patients <60 years old would perceive greater lumbar stiffness–related functional limitation following fusion for adult spinal deformity. Methods: Patients completed the LSDI and Scoliosis Research Society 22 Questionnaire, Revised (SRS-22r) preoperatively and at 2 years postoperatively. The primary independent variable was patient age <60 versus ≥60. Multivariable regression analyses were used. Results: Analysis included 267 patients. Patients <60 years old (51.3%) and ≥60 years old (48.7%) were evenly represented. In bivariable analysis, patients age <60 exhibited lower LSDI at baseline versus patients age ≥60 (25.7 vs. 35.5, β −9.8, P < 0.0001), but a directionally smaller difference at 2 years (26.4 vs. 32.3, β −5.8, P = 0.0147). LSDI was associated with lower SRS-22r total score among both age groups at baseline and 2 years (all P < 0.0001); the association was stronger among patients age <60 versus ≥60 at 2 years. LSDI was associated with SRS-22r satisfaction scores at 2 years among patients age <60 (P < 0.0001), but not patients age ≥60 (P = 0.2250). The difference in SRS-22r satisfaction per unit LSDI between patients <60 years old and ≥60 years old was significant (P = 0.0021). Conclusions: Among patients with adult spinal deformity managed operatively, higher LSDI was associated with inferior SRS-22r total score and satisfaction at 2 years postoperatively. The association between increased LSDI and worse patient-reported outcome measures was greater among patients age <60 versus ≥60. Preoperative counseling is needed for patients age <60 undergoing adult spinal deformity surgery regarding effects that lumbar stiffness may have on postoperative function and satisfaction.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Scoliosis
Research
Spinal Fusion
Activities of Daily Living
Counseling
Age Groups
Regression Analysis
Surveys and Questionnaires

Keywords

  • Adult spinal deformity
  • HRQOL
  • Lumbar spine stiffness

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Younger Patients Are Differentially Affected by Stiffness-Related Disability Following Adult Spinal Deformity Surgery. / International Spine Study Group.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Younger Patients Are Differentially Affected by Stiffness-Related Disability Following Adult Spinal Deformity Surgery",
abstract = "Objective: The Lumbar Stiffness Disability Index (LSDI) assesses impact of lumbar stiffness on activities of daily living. We hypothesized that patients <60 years old would perceive greater lumbar stiffness–related functional limitation following fusion for adult spinal deformity. Methods: Patients completed the LSDI and Scoliosis Research Society 22 Questionnaire, Revised (SRS-22r) preoperatively and at 2 years postoperatively. The primary independent variable was patient age <60 versus ≥60. Multivariable regression analyses were used. Results: Analysis included 267 patients. Patients <60 years old (51.3{\%}) and ≥60 years old (48.7{\%}) were evenly represented. In bivariable analysis, patients age <60 exhibited lower LSDI at baseline versus patients age ≥60 (25.7 vs. 35.5, β −9.8, P < 0.0001), but a directionally smaller difference at 2 years (26.4 vs. 32.3, β −5.8, P = 0.0147). LSDI was associated with lower SRS-22r total score among both age groups at baseline and 2 years (all P < 0.0001); the association was stronger among patients age <60 versus ≥60 at 2 years. LSDI was associated with SRS-22r satisfaction scores at 2 years among patients age <60 (P < 0.0001), but not patients age ≥60 (P = 0.2250). The difference in SRS-22r satisfaction per unit LSDI between patients <60 years old and ≥60 years old was significant (P = 0.0021). Conclusions: Among patients with adult spinal deformity managed operatively, higher LSDI was associated with inferior SRS-22r total score and satisfaction at 2 years postoperatively. The association between increased LSDI and worse patient-reported outcome measures was greater among patients age <60 versus ≥60. Preoperative counseling is needed for patients age <60 undergoing adult spinal deformity surgery regarding effects that lumbar stiffness may have on postoperative function and satisfaction.",
keywords = "Adult spinal deformity, HRQOL, Lumbar spine stiffness",
author = "{International Spine Study Group} and Durand, {Wesley M.} and Daniels, {Alan H.} and Hamilton, {David K.} and Passias, {Peter G.} and Kim, {Han Jo} and Themistocles Protopsaltis and Virginie Lafage and Smith, {Justin S.} and Christopher Shaffrey and Munish Gupta and Kelly, {Michael P.} and Eric Klineberg and Frank Schwab and Doug Burton and Shay Bess and Christopher Ames and Robert Hart",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2019.08.169",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

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T1 - Younger Patients Are Differentially Affected by Stiffness-Related Disability Following Adult Spinal Deformity Surgery

AU - International Spine Study Group

AU - Durand, Wesley M.

AU - Daniels, Alan H.

AU - Hamilton, David K.

AU - Passias, Peter G.

AU - Kim, Han Jo

AU - Protopsaltis, Themistocles

AU - Lafage, Virginie

AU - Smith, Justin S.

AU - Shaffrey, Christopher

AU - Gupta, Munish

AU - Kelly, Michael P.

AU - Klineberg, Eric

AU - Schwab, Frank

AU - Burton, Doug

AU - Bess, Shay

AU - Ames, Christopher

AU - Hart, Robert

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: The Lumbar Stiffness Disability Index (LSDI) assesses impact of lumbar stiffness on activities of daily living. We hypothesized that patients <60 years old would perceive greater lumbar stiffness–related functional limitation following fusion for adult spinal deformity. Methods: Patients completed the LSDI and Scoliosis Research Society 22 Questionnaire, Revised (SRS-22r) preoperatively and at 2 years postoperatively. The primary independent variable was patient age <60 versus ≥60. Multivariable regression analyses were used. Results: Analysis included 267 patients. Patients <60 years old (51.3%) and ≥60 years old (48.7%) were evenly represented. In bivariable analysis, patients age <60 exhibited lower LSDI at baseline versus patients age ≥60 (25.7 vs. 35.5, β −9.8, P < 0.0001), but a directionally smaller difference at 2 years (26.4 vs. 32.3, β −5.8, P = 0.0147). LSDI was associated with lower SRS-22r total score among both age groups at baseline and 2 years (all P < 0.0001); the association was stronger among patients age <60 versus ≥60 at 2 years. LSDI was associated with SRS-22r satisfaction scores at 2 years among patients age <60 (P < 0.0001), but not patients age ≥60 (P = 0.2250). The difference in SRS-22r satisfaction per unit LSDI between patients <60 years old and ≥60 years old was significant (P = 0.0021). Conclusions: Among patients with adult spinal deformity managed operatively, higher LSDI was associated with inferior SRS-22r total score and satisfaction at 2 years postoperatively. The association between increased LSDI and worse patient-reported outcome measures was greater among patients age <60 versus ≥60. Preoperative counseling is needed for patients age <60 undergoing adult spinal deformity surgery regarding effects that lumbar stiffness may have on postoperative function and satisfaction.

AB - Objective: The Lumbar Stiffness Disability Index (LSDI) assesses impact of lumbar stiffness on activities of daily living. We hypothesized that patients <60 years old would perceive greater lumbar stiffness–related functional limitation following fusion for adult spinal deformity. Methods: Patients completed the LSDI and Scoliosis Research Society 22 Questionnaire, Revised (SRS-22r) preoperatively and at 2 years postoperatively. The primary independent variable was patient age <60 versus ≥60. Multivariable regression analyses were used. Results: Analysis included 267 patients. Patients <60 years old (51.3%) and ≥60 years old (48.7%) were evenly represented. In bivariable analysis, patients age <60 exhibited lower LSDI at baseline versus patients age ≥60 (25.7 vs. 35.5, β −9.8, P < 0.0001), but a directionally smaller difference at 2 years (26.4 vs. 32.3, β −5.8, P = 0.0147). LSDI was associated with lower SRS-22r total score among both age groups at baseline and 2 years (all P < 0.0001); the association was stronger among patients age <60 versus ≥60 at 2 years. LSDI was associated with SRS-22r satisfaction scores at 2 years among patients age <60 (P < 0.0001), but not patients age ≥60 (P = 0.2250). The difference in SRS-22r satisfaction per unit LSDI between patients <60 years old and ≥60 years old was significant (P = 0.0021). Conclusions: Among patients with adult spinal deformity managed operatively, higher LSDI was associated with inferior SRS-22r total score and satisfaction at 2 years postoperatively. The association between increased LSDI and worse patient-reported outcome measures was greater among patients age <60 versus ≥60. Preoperative counseling is needed for patients age <60 undergoing adult spinal deformity surgery regarding effects that lumbar stiffness may have on postoperative function and satisfaction.

KW - Adult spinal deformity

KW - HRQOL

KW - Lumbar spine stiffness

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