Study Design: Multicenter, international prospective study.
Objective: This study investigated the clinical outcome up to 2 years after multi-level spinal deformity surgery in the elderly by reporting the minimal clinically important difference (MCID) of EuroQol 5-dimensions (EQ-5D), EQ-VAS, and residential status.
Methods: As an ancillary study of 219 patients ≥60 years with spinal deformity undergoing primary instrumented fusion surgery of ≥5 levels, this study focuses on EQ-5D (3-L) as the primary outcome and EQ-VAS and residential status as secondary outcomes. Data on EQ-5D were compared between pre-operatively and postoperatively at 10 weeks, 12 months, and 24 months. An anchor-based approach was used to calculate the MCID.
Results: The EQ-5D index and EQ-VAS, respectively, improved significantly at each time point compared to pre-operatively (from .53 (SD .21) and 55.6 (SD 23.0) pre-operatively to .64 (SD .18) and 65.8 (SD 18.7) at 10 weeks, .74 (SD .18) and 72.7 (SD 18.1) at 12 months, and .73 (SD .20) and 70.4 (SD 20.4) at 24 months). 217 (99.1%) patients lived at home pre-operatively, while 186 (88.6%), 184 (98.4%), and 172 (100%) did so at 10 weeks, 12 months, and 24 months, respectively. Our calculated MCID for the EQ-5D index at 1 year was .22 (95% CI .15-.29).
Conclusions: The EQ-5D index significantly increased at each time point over 24 months after ≥5 level spinal deformity surgery in elderly patients. The MCID of the EQ-5D-3 L was .22. Patients living at home pre-operatively can expect to be able to live at home 2 years postoperatively.
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http://dx.doi.org/10.1177/21925682231162574 | DOI Listing |
Eur Spine J
January 2025
Service de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1 Avenue Molière, Strasbourg, France.
Introduction: In asymptomatic subjects, variations of sagittal alignment parameters according to age and pelvic incidence (PI) has been reported. The aim of this observational study was to describe thoraco-lumbar sagittal alignment in patients with degenerative scoliosis and to compare them to asymptomatic individuals, seeking for the specific effect of deformity in similar age and PI groups.
Materials And Methods: Full spine radiographs of 235 asymptomatic subjects and 243 scoliosis patients were analyzed: cervico-thoracic inflexion point (CTIP), thoraco-lumbar inflexion point (TLIP), lumbar lordosis (LL) L1-S1, LL (TLIP-S1), LL superior arch (TLIP-lumbar apex), LL inferior arch (lumbar apex-S1), PI, thoracic kyphosis (TK) T5-T12, TK T1-T12, number of vertebrae CTIP-TLIPandTLIP-S1.
Spine Deform
January 2025
Department of Orthopaedic Surgery, Scottish Rite Hospital for Children, Dallas, TX, USA.
Purpose: The etiology of early-onset scoliosis (EOS) has been shown to significantly influence baseline parent-reported health-related quality of life (HrQOL). In combining these etiology groups, we obligatorily lump together many disparate diagnoses, particularly true in the neuromuscular (NM) cohort. We sought to evaluate the influence of underlying neuromuscular diagnosis on the HrQOL at 5 years following surgery for EOS.
View Article and Find Full Text PDFSpine J
January 2025
International Spine Study Group Foundation, Denver, Colorado, USA.
Background Context: Correcting sagittal malalignment in adult spinal deformity (ASD) is a challenging task, often requiring complex surgical interventions like pedicle subtraction osteotomies (PSOs). Different types of three-column osteotomies (3COs), including Schwab 3, Schwab 4, Schwab 4 with interbody cages, and the "sandwich" technique, aim to optimize alignment and fusion outcomes. The role of interbody cages in enhancing fusion and segmental correction remains unclear.
View Article and Find Full Text PDFSpine J
January 2025
Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing 100191, China; Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing 100191, China. Electronic address:
Background Context: Osteoporotic vertebral compression fracture (OVCF) causes pain, kyphosis and neurological damage, which significantly affect patients' quality of life. Patients with OVCF are often elderly and have severe osteoporosis, which makes preoperative symptom more serious, postoperative recovery worse and the incidence of postoperative complications high. The paraspinal muscles have been well studied in adult spinal deformities, but there is no conclusive evidence that their findings can be applied to OVCF.
View Article and Find Full Text PDFEnviron Res
January 2025
School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; National Institute of Science and Technology for Detection, Toxicological Evaluation and Removal of Micropollutants and Radioactive Substances (INCT-DATREM). Electronic address:
Diisopentyl phthalate (DiPP) is present in many consumer goods, but can be absorbed into the human body, and can disrupt the endocrine system affecting reproductive health and fetal development. Studies revealed that biological samples of pregnant women in Brazil contained DiPP, raising even more the concerns about its usage. This study investigated how DiPP concentrations (12.
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