AI Article Synopsis
- Coronal balance plays a crucial role in the surgical success of adult spinal deformity (ASD), and the Obeid coronal malalignment (O-CM) classification aims to enhance surgical outcomes by improving alignment.
- At a 2-year follow-up, patients whose surgeries adhered to the O-CM guidelines experienced a lower rate of mechanical complications (40% vs. 60%) and significant improvements in patient-reported outcome scores.
- A post-surgery coronal alignment correction to less than 20 mm was linked to better functional outcomes and a 3.5 times higher likelihood of achieving essential clinical improvements in the SRS-22 score.
Article Abstract
Purpose: Coronal balance is a major factor impacting the surgical outcomes in adult spinal deformity (ASD). The Obeid coronal malalignment (O-CM) classification has been proposed to improve the coronal alignment in ASD surgery. Aim of this study was to investigate whether a postoperative CM < 20 mm and adherence to the O-CM classification could improve surgical outcomes and decrease the rate of mechanical failure in a cohort of ASD patients.
Methods: Multicenter retrospective analysis of prospectively collected data on all ASD patients who underwent surgical management and had a preoperative CM > 20 mm and a 2-year follow-up. Patients were divided in two groups according to whether or not surgery had been performed in adherence to the guidelines of the O-CM classification and according to whether or not the residual CM was < 20 mm. The outcomes of interest were radiographic data, rate of mechanical complications and Patient-Reported Outcome Measures.
Results: At 2 years, adherence to the O-CM classification led to a lower rate of mechanical complications (40 vs. 60%). A coronal correction of the CM < 20 mm allowed for a significant improvement in SRS-22 and SF-36 scores and was associated with a 3.5 times greater odd of achieving the minimal clinical important difference for the SRS-22.
Conclusion: Adherence to the O-CM classification could reduce the risk of mechanic complications 2 years after ASD surgery. Patients with a residual CM < 20 mm showed better functional outcomes and a 3.5 times greater odd of achieving the MCID for the SRS-22 score.
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| http://dx.doi.org/10.1007/s00586-023-07831-0 | DOI Listing |
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