Clinical and radiological outcomes after decompression and posterior fusion in patients with degenerative scoliosis

Farrokhi, Majid Reza; Jamali, Mohammad; Gholami, Mehrnaz; Farrokhi, Farnaz; Hosseini, Khadijeh

doi:10.1080/02688697.2017.1317717

Cited by 12 publications

(11 citation statements)

References 82 publications

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“…The surgical effectiveness of spinal surgery in leading to significant and sustained improvements in patient-reported disability and overall outcomes has been previously reported. 2,8,9,16,18 In our study, we observed the greatest magnitude of change in baseline to follow-up ODI; on the level of the individual SRS-22r domains, our cohort showed the greatest improvement from baseline in the self-image domain, with function, pain, and mental health showing less but still substantial and sig- nificant improvement from baseline. The finding that selfimage may be subject to the greatest benefit of all SRS-22r domains after correction of complex deformities has been previously reported.…”

Section: Discussionsupporting

confidence: 44%

“…8 Other studies have reported substantial improvements in patient perceptions of disability as evidenced by significant reductions in ODI after spinal fusion. 10,12,15,18,21 Due to this potential for significant improvement in both perceptions of disability and self-image, longitudinal assessment of PROs in spinal deformity patients, especially in those undergoing complex fusions, is important in the evaluation of overall surgical outcomes. Collecting PROs at multiple follow-ups after spinal surgery is important, as patients continue to experience significant changes in healthcare quality-of-life measures owing to their deformity correction up to a year after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of 2-year SRS-22r and ODI patient-reported outcomes with 5-year patient-reported outcomes after complex spinal fusion: a 5-year single-institution study of 118 patients

Adogwa

Karikari

Elsamadicy

et al. 2018

Journal of Neurosurgery: Spine

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OBJECTIVEPatient-reported outcomes (PROs) are often measured up to 2 years after surgery; however, prospective collection of longitudinal outcomes for 5 years postoperatively can be challenging due to lack of patient follow-up. The aim of this study was to determine whether PROs collected at 2-year follow-up accurately predict long-term PROs 5 years after complex spinal fusion (≥ 5 levels).METHODSThis was an ambispective study of 118 adult patients (≥ 18 years old) undergoing ≥ 5-level spinal arthrodesis to the sacrum with iliac fixation from January 2002 to December 2011. Patient demographics and radiographic parameters as well as intraoperative variables were collected. PRO instruments (Scoliosis Research Society [SRS]-22r function, self-image, mental health, pain, and Oswestry Disability Index [ODI]) were completed before surgery then at 2 and 5 years after surgery. Primary outcome investigated in this study was the correlation between SRS-22r domains and ODI collected at 2- and 5-year follow-up.RESULTSOf the 118 patients, 111 patients had baseline PROs, 105 patients had 2-year follow-up data, and 91 patients had 5-year follow-up PRO data with 72% undergoing revision surgery. The average pre- and postoperative major coronal curve Cobb angles for the cohort were 32.1° ± 23.7° and 19.8° ± 19.3°, respectively. There was a strong correlation between 2- and 5-year ODI (r2 = 0.80, p < 0.001) and between 2- and 5-year SRS-22r domains, including function (r2 = 0.79, p < 0.001), self-image (r2 = 0.82, p < 0.001), mental health (r2 = 0.77, p < 0.001), and pain (r2 = 0.79, p < 0.001). Of the PROs, ODI showed the greatest absolute change from baseline to 2- and 5-year follow-up (2-year Δ 17.6 ± 15.9; 5-year Δ 16.5 ± 19.9) followed by SRS-22r self-image (2-year Δ 1.4 ± 0.96; 5-year Δ 1.3 ± 1.0), pain (2-year Δ 0.94 ± 0.97; 5-year Δ 0.80 ± 1.0), function (2-year Δ 0.60 ± 0.62; 5-year Δ 0.49 ± 0.79), and mental health (2-year Δ 0.49 ± 0.77; 5-year Δ 0.38 ± 0.84).CONCLUSIONSPatient-reported outcomes collected at 2-year follow-up may accurately predict long-term PROs (5-year follow-up).

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Correlation of 2-year SRS-22r and ODI patient-reported outcomes with 5-year patient-reported outcomes after complex spinal fusion: a 5-year single-institution study of 118 patients

Adogwa

Karikari

Elsamadicy

et al. 2018

Journal of Neurosurgery: Spine

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“…All the patients underwent partial decompressive laminectomy, PLF and spinal fixation with pedicular screws and rods (Implants International Ltd., Teesside industrial estate, Thornby, United Kingdom) [30,31]. PLF was done using bone graft and bone substitute.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Treatment of 44 Cases With Lumbar Spine Stenosis and Degenerative Instability: Outcomes of Surgical Intervention

Farrokhi

Yadollahikhales

Gholami

2017

IrJNS

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Background and Aim: Degenerative lumbar spine disease can lead to lumbar spine instability. The patients can present with Low Back Pain (LBP), radicular pain, and motor and sensory dysfunction. Age >50, female sex and pregnancies are among prevalent risk factors. The degeneration process usually starts from the intervertebral discs progressing to involve facet joints, ligaments, and vertebral bodies leading to spinal instability and deformity. This study aims to evaluate the effect of lumbar decompression and Posterolateral Fusion (PLF) on the short-and long-term outcomes of these patients. Methods and Materials/Patients:This prospective study assessed the effect of lumbar decompression and PLF in patients with lumbar instability referred to the Neurosurgery Clinic of Chamran hospital between March 2011 and March 2013. Forty-four patients with degenerative lumbar spine instability and stenosis were eligible for participation to undergo lumbar decompression and PLF. Its clinical effect was evaluated using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). The change in sagittal and coronal planes was also assessed according to pre-and post-operative findings at 2-year follow-up. The statistical method of assessment was repeated using paired t-test. P<0.05 was considered statistically significant. Results:The mean preoperative VAS score decreased significantly at 2 years after the surgery (6.87±1.07 vs. 2.20±1.15; P<0.001). The comparison between preoperative ODI and its 6-month, 1 and 2-year counterparts showed a significant improvement (P<0.001). Moreover, 82.7% of the patients showed a good fusion rate. The sagittal and coronal angles were reduced significantly after the surgery (P<0.05). Short vs. long segment fusion and inclusion of sacral body did not significantly affect the VAS, ODI scores and the deformity angles. Conclusion:Lumbar decompression and PLF is a safe and effective method for patients suffering from degenerative lumbar instability.

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“…In another study by Papp et al (9) the transoral vertebroplasty of C2 metastatic lesion was practiced, followed by posterior fusion. We believe that vertebroplasty not only alleviates pain but also enhances the biomechanical properties of the axis to withstand axial load and in the absence of pre-operative overt instability, posterior fusion is necessary (10). However, posterior fusion limits motion so it can negatively affect the quality of life.…”

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confidence: 99%

Standalone Transoral Vertebroplasty for Treatment of Painful Metastatic C2 Lesion: A Case Report

et al. 2019

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Introduction: Metastatic involvement of the spine may present with pathologic fractures, deformity, neurologic deficit due to vertebral canal compromise, and pain. Pain is usually managed with non-steroidal anti-inflammatory agents, corticosteroid injections, calcitonin, etc. Since the introduction of percutaneous vertebroplasty in 1984, it has proven as an effective armamentarium in the management of painful metastatic spine lesions. Herein, we present a case of breast cancer with osteolytic C2 metastasis, for whom trans-oral vertebroplasty without posterior fusion resulted in long-standing pain control and maintenance of normal motions and stability. Case Presentation: A 41-year-old woman, a known case of breast cancer with severe neck pain for three months, was admitted due to an osteolytic lesion in C2. The pain was incapacitating and resistant to conservative measures. Standalone transoral vertebroplasty resulted in pain control and a three-year follow-up showed durable control of pain. After positioning the patient and insertion of Dingman mouth gag, the oropharynx was prepped and injected with epinephrine/lidocaine solution. Under biplanar fluoroscopic guidance, a needle was introduced into the C2 body through the oropharynx. The lytic lesion was filled with about 2 cc of PMMA cement. The VAS score decreased from 10 prior to operation to 5 immediately after recovery from general anesthesia and improved to 2 after six months. At a 36-month follow-up visit, the VAS score was 0, normal cervical motions were preserved, and lateral neutral and dynamic cervical X-rays disclosed stability. Conclusions: Standalone transoral vertebroplasty can be safely practiced as an effective treatment for painful osteolytic metastases of C2 with normal dynamics.

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Clinical and radiological outcomes after decompression and posterior fusion in patients with degenerative scoliosis

Cited by 12 publications

References 82 publications

Correlation of 2-year SRS-22r and ODI patient-reported outcomes with 5-year patient-reported outcomes after complex spinal fusion: a 5-year single-institution study of 118 patients

Correlation of 2-year SRS-22r and ODI patient-reported outcomes with 5-year patient-reported outcomes after complex spinal fusion: a 5-year single-institution study of 118 patients

Treatment of 44 Cases With Lumbar Spine Stenosis and Degenerative Instability: Outcomes of Surgical Intervention

Standalone Transoral Vertebroplasty for Treatment of Painful Metastatic C2 Lesion: A Case Report

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