A decision analysis to identify the ideal treatment for adult spinal deformity: is surgery better than non-surgical treatment in improving health-related quality of life and decreasing the disease burden?

Acaroğlu, Emre; Cetinyurek-Yavuz, Aysun; Güler, Ümit Özgür; Yüksel, Selcen; Yavuz, Yasemin; Domingo-Sàbat, Montserrat; Pellisé, Ferran; Alanay, Ahmet; Grueso, Francesco Sanchez Perez; Kleinstück, Frank; Obeid, Ibrahim

doi:10.1007/s00586-016-4413-8

Cited by 72 publications

(42 citation statements)

References 10 publications

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“…Despite this prevalence, many patients have mild deformities and little or no symptoms. Conversely some patients have marked spinal deformity with global spinal imbalance causing severe disability [4]. The predominant reason for this disability is that spinal imbalance prevents the normal economic resting posture of the spine, whereby the centre of gravity runs in close proximity to the spine and the head is centred over the hips.…”

Section: Introductionmentioning

confidence: 99%

The Functional Effects of Adult Spinal Deformity and the Effectiveness of Surgery

Kieser¹,

Wyatt²

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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The prevalence of adult spinal deformity (ASD) is increasing worldwide, driven by changing patient demographics, as well as an increased capacity to diagnose and treat this condition. ASD carries the worst healthcare burden of all chronic conditions including arthritis, chronic lung disease, congestive heart failure, diabetes and ischaemic heart disease. Recent advances in diagnostic and treatment modalities have resulted in an increase in surgical intervention for this condition. To be successful, however, a comprehensive understanding of the functional deficits caused by ASD must be recognised by those clinicians managing such patients. This chapter provides an overview of the functional deficits caused by ASD and its treatment.

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Section: Introductionmentioning

confidence: 99%

The Functional Effects of Adult Spinal Deformity and the Effectiveness of Surgery

Kieser¹,

Wyatt²

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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“…Recent studies have shown that ASD negatively affects health-related quality of life [7,8]. Surgical 4 treatment has been shown to provide better health-related quality of life outcomes than non-surgical treatment, especially in patients with severe deformity [9]. However, high complication rates have been reported with revision rates of up to 47%.…”

Section: Introductionmentioning

confidence: 99%

“…Reports have shown that these postural abnormalities increase susceptibility to rigid spinal deformities [2,3] and that patients with PD develop adult spinal deformity (ASD) more frequently than the general population in the same age groups [6].Recent studies have shown that ASD negatively affects health-related quality of life [7,8]. Surgical 4 treatment has been shown to provide better health-related quality of life outcomes than non-surgical treatment, especially in patients with severe deformity [9]. However, high complication rates have been reported with revision rates of up to 47%.…”

mentioning

confidence: 99%

Sagittal alignment changes and postoperative complications after adult spinal deformity surgery in patients with Parkinson’s disease: A multi-institutional retrospective study

Kawabata

Yoshii

Sakai

et al. 2020

Preprint

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Background: Parkinson's disease (PD) has been reported to increase the risk of postoperative complications in patients with adult spinal deformity (ASD). However, those reports are limited, and few have made direct comparisons with patients who do not have PD. Methods:We retrospectively reviewed all surgically treated patients with ASD and at least 2 years of follow-up. Among them, 27 had PD (PD(+) group). Clinical data were collected on early and late postoperative complications and revision surgery. Radiographic parameters were evaluated before and immediately after surgery and at final follow-up, including sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis, sacral slope, and pelvic tilt. From the same database, we also retrieved 206 controls without PD (PD(−) group) matched for age, sex, and body mass index.Results: For early complications, the PD(+) group showed a higher rate of delirium than the PD(−) group. Deep vein thrombosis and pulmonary embolism rates tended to be higher in the PD(+) group.For late complications, the rate of pseudarthrosis was significantly higher in the PD(+) group. Rates of rod failure and revision surgery due to mechanical complications also tended to be higher, but not significantly, in the PD(+) group (p = 0.17, p = 0.13, respectively). SVA at final follow-up and loss of correction in SVA were significantly higher in the PD(+) group.Conclusion: Extra attention should be paid to perioperative complications, especially delirium and thrombosis, in PD patients undergoing surgery for ASD. Furthermore, loss of correction and rate of revision surgery due to mechanical complications were higher in these patients. BackgroundParkinson's disease (PD) is a neurodegenerative disorder, the main symptoms of which are rigidity, bradykinesia, and gait disorder. With population aging, the number of patients with this age-related disorder is increasing [1]. In severe cases, PD causes postural disorder, such as anterocollis, Pisa syndrome, and camptocormia [2][3][4][5]. Reports have shown that these postural abnormalities increase susceptibility to rigid spinal deformities [2,3] and that patients with PD develop adult spinal deformity (ASD) more frequently than the general population in the same age groups [6].Recent studies have shown that ASD negatively affects health-related quality of life [7,8]. Surgical 4 treatment has been shown to provide better health-related quality of life outcomes than non-surgical treatment, especially in patients with severe deformity [9]. However, high complication rates have been reported with revision rates of up to 47%. Surgical complications are generally divided into perioperative and late complications. Perioperative complications include epidural hematoma, deep vein thrombosis (DVT), and pulmonary embolism (PE), which are usually seen during or soon after surgery. Late complications, such as junctional kyphosis, rod fracture, and pseudarthrosis, typically occur more than 1 month after surgery and are mainly caused by continuous mechanical stress.Ge...

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“…Recent studies have shown that ASD negatively affects health-related quality of life [7,8]. Surgical treatment has been shown to provide better health-related quality of life outcomes than non-surgical treatment, especially in patients with severe deformity [9]. However, high complication rates have been reported with revision rates of up to 47%.…”

Section: Introductionmentioning

confidence: 99%

Sagittal alignment changes and postoperative complications following surgery for adult spinal deformity in patients with Parkinson’s disease: a multi-institutional retrospective cohort study

Kawabata

Yoshii

Sakai

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Parkinson’s disease (PD) has been reported to increase the risk of postoperative complications in patients with adult spinal deformity (ASD). However, those studies are limited, and few have made direct comparisons with patients who do not have PD. Methods: A retrospective cohort study. We retrospectively reviewed all surgically treated ASD patients with at least a 2-year follow-up. Among them, 27 had PD (PD(+) group). Clinical data were collected on early and late postoperative complications as well as any revision surgery. Radiographic parameters were evaluated before and immediately after surgery and at final follow-up, including sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis, sacral slope, and pelvic tilt. We compared the surgical outcomes and radiographic parameters of PD patients with those of non-PD patients. Results: For early complications, the PD(+) group demonstrated a higher rate of delirium than the PD(−) group. Deep vein thrombosis and pulmonary embolism rates tended to be higher in the PD(+) group. With regard to late complications, the rate of pseudarthrosis was significantly higher in the PD(+) group. Rates of rod failure and revision surgery due to mechanical complications also tended to be higher, but not significantly, in the PD(+) group ( p = 0.17, p = 0.13, respectively). SVA at final follow-up and loss of correction in SVA were significantly higher in the PD(+) group. Conclusion: Extra attention should be paid to perioperative complications, especially delirium and thrombosis, in PD patients undergoing surgery for ASD. Furthermore, loss of correction and rate of pseudarthrosis were greater in these patients.

show abstract

A decision analysis to identify the ideal treatment for adult spinal deformity: is surgery better than non-surgical treatment in improving health-related quality of life and decreasing the disease burden?

Cited by 72 publications

References 10 publications

The Functional Effects of Adult Spinal Deformity and the Effectiveness of Surgery

The Functional Effects of Adult Spinal Deformity and the Effectiveness of Surgery

Sagittal alignment changes and postoperative complications after adult spinal deformity surgery in patients with Parkinson’s disease: A multi-institutional retrospective study

Sagittal alignment changes and postoperative complications following surgery for adult spinal deformity in patients with Parkinson’s disease: a multi-institutional retrospective cohort study

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