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

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>Patient-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).</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>This 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.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Of 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 (r<jats:sup>2</jats:sup> = 0.80, p &lt; 0.001) and between 2- and 5-year SRS-22r domains, including function (r<jats:sup>2</jats:sup> = 0.79, p &lt; 0.001), self-image (r<jats:sup>2</jats:sup> = 0.82, p &lt; 0.001), mental health (r<jats:sup>2</jats:sup> = 0.77, p &lt; 0.001), and pain (r<jats:sup>2</jats:sup> = 0.79, p &lt; 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).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Patient-reported outcomes collected at 2-year follow-up may accurately predict long-term PROs (5-year follow-up).</jats:p></jats:sec>

Improvement in SRS-22R Self-Image Correlate Most with Patient Satisfaction after 3-Column Osteotomy

“…To our knowledge, previous studies have not demonstrated a relationship between patient satisfaction and changes in SRS-22R domain scores in ASD patients undergoing a 3CO 1,23,24 . In a multicenter study evaluating 147 consecutive pediatric patient undergoing 3CO Lenke et al reported significant improvements in the SRS-30 Self-Image, function, mental health, and satisfaction domains at a 1-year follow-up 25 .…”

“…To our knowledge, previous studies have not demonstrated a relationship between patient satisfaction and changes in SRS-22R domain scores in ASD patients undergoing a 3CO. 1,23,24 In a multicenter study evaluating 147 consecutive pediatric patient undergoing 3CO Lenke et al reported significant improvements in the SRS-30 Self-Image, function, mental health, and satisfaction domains at a 1-year follow-up. 25 Hamilton et al prospectively studied 248 patients across 11 centers undergoing ASD sugary and demonstrated greater improvement in final ODI, SF-36 component scores, SRS-Total, and Visual Analogue Scale back scores (P < 0.05).…”

Patient-Reported Outcomes After Complex Adult Spinal Deformity Surgery: 5-Year Results of the Scoli-Risk-1 Study

“…Alternatively, the number of patients lost to follow-up may represent a skewed sample of patients happier with their care. 32 …”

Correlation of Acetabular Anteversion and Thoracic Kyphosis Postoperatively with Proximal Junctional Failure in Adult Spinal Deformity Fused to Pelvis

“…ASD is highly prevalent in individuals over 65 years, affecting almost 68% of that population 1 . Previous studies demonstrated that ASD patients underwent scoliosis surgery reported statistically significant improvements in all health related quality of life (HRQOL) compared with those received non‐operative treatment 2 , 3 , 4 . Generally, scoliosis surgery relies strongly on pedicle screw internal instrumentations, which can provide remarkable correction force and achieve a significant fusion rate.…”