Activity of Daily Living After Long Level Fusion in Adult Spinal Deformity

Kim, Whoan Jeang; Lee, Jae Won; Hwang, Seok Young; Park, Kun Young; Chang, Shann Haw; Song, Dae Geon; Choy, Won Sik

doi:10.1097/brs.0000000000002676

Cited by 6 publications

(12 citation statements)

References 28 publications

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“…Before surgery, patients should be made aware of the fact that higher ASA scores are associated with both perioperative complications and increased SRFD. Similar to the findings of past studies, 7,[9][10][11][12]17 fusion length was significantly correlated with SRFD for sanitation activity, lower body activities, and total sum. However, sitting on the floor was not affected by fusion length.…”

Section: Key Results and Interpretationsupporting

confidence: 88%

“…However, contrary to our expectations, the sagittal parameters including LL, sacral slope, PT, thoracic kyphosis, and SVA did not show a significant correlation with SRFD, except for PI-LL, which only correlated with 1 category (lower body activities). Furthermore, the study by Kim et al 10 showed that PI-LL, PT, and SVA did not affect daily living activities after long segmental fusion. The results of our study were on similar grounds to that study.…”

Section: Key Results and Interpretationmentioning

confidence: 94%

“…There was no significant change between 1 and 2 years after surgery, and the degree of change was not significant after that. 10,11 Based on these results, we presumed that patients would be adapted to the activities of daily living at 2 years postoperatively and that the evaluation of SRFD during that time would be appropriate.…”

Section: Limitationsmentioning

confidence: 99%

“…9,10,12,17 The component items in each system are somewhat different from each other, but it is consistently reported that SRFD is expected to increase with increasing fusion length. 7,[9][10][11][12]17 However, the authors of the present work have seen patients who experience different degrees of SRFD despite having undergone the same level fusion. We postulate that other factors besides the fusion level-such as the development of proximal junctional kyphosis, use of iliac fixation, or degree of correction in lumbar lordosis-could affect the degree of SRFD.…”

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confidence: 99%

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confidence: 99%

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Factors Affecting Stiffness-Related Functional Disability After Long Segmental Fusion for Adult Spinal Deformity

et al. 2022

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BACKGROUND:In general, stiffness-related functional disability (SRFD) is expected to increase as longer fusion length, but there have been no studies on factors affecting SRFD besides fusion length.OBJECTIVE:To identify the factors affecting SRFD after long segmental fusion in patients with adult spinal deformity (ASD).METHODS:We retrospectively reviewed the patients who underwent ≥4-segment fusion including sacrum for ASD. The severity of SRFD was evaluated using the Specific Functional Disability Index (SFDI) consisting of 12 items with 4 categories as follows: sitting on the floor, sanitation activity, lower body activity, and moving activity. Each category contains 3 items which was given a maximum of 4 points. The presumed factors affecting SFDI were analyzed.RESULTS:A total of 148 patients were included in the study with their mean age of 67.3 years. The mean fusion length was 6.4 segments. The mean score of each SFDI category was highest in sitting on the floor (9.9), followed by lower body activities (7.6), sanitation activities (6.0), and moving activities (5.9). The total sum was 29.3 points. In multivariate analysis, total sum of SFDI was significantly higher in female sex, patients with higher American Society of Anesthesiology grade, and longer fusion length. However, the sagittal parameters did not show a significant correlation with SRFD, except pelvic incidence-lumbar lordosis which correlated with only one category (lower body activities).CONCLUSION:This study showed that female sex, higher American Society of Anesthesiology grades, and longer fusion length influenced SRFD after long segmental fusion for ASD. Sagittal parameters related to the degree of deformity correction did not significantly affect SRFD.

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Section: Key Results and Interpretationsupporting

confidence: 88%

Section: Key Results and Interpretationmentioning

confidence: 94%

Section: Limitationsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Factors Affecting Stiffness-Related Functional Disability After Long Segmental Fusion for Adult Spinal Deformity

et al. 2022

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Stiffness-related disability following long segmental posterior instrumentation and fusion: is it influenced by postoperative spinopelvic alignment?

Zhang,

Liu,

Zeng

et al. 2024

Eur Spine J

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Purpose The aims of this study were to investigate the correlations between Chinese version of Lumbar Stiffness Disability Index (C-LSDI) and other clinical outcomes, and to identify the factors independently affecting stiffness-related disability after long-segment fusion in patients with degenerative lumbar scoliosis (DLS). Methods We performed a retrospective study of 118 consecutive surgically treated DLS cases at a single institute. Pre- and post-operative radiological parameters and postoperative health related quality of life (HRQOL) were examined to determine their correlation coefficients with postoperative C-LSDI. Patients were divided into two groups by the medium number of postoperative C-LSDI: low-stiffness group (C-LSDI < 48 points) and high-stiffness group (C-LSDI ≥ 48 points). Subsequently, differences between the two groups were assessed, and the presumed factors affecting C-LSDI evaluation were further analyzed. Results Coronal parameters and global sagittal parameters showed significant correlations with postoperative C-LSDI. The correlation coefficients between C-LSDI and Oswestry Disability Index (ODI), Japanese Orthopedic Association-29 (JOA-29), the Scoliosis Research Society-22 questionnaire (SRS-22) Function, and the Short Form-36 Health Survey (SF-36) Physical Component Scores were over 0.5. In multiple linear regression, postoperative sagittal vertical axis (β = 0.084, p = 0.025), fusion levels (β = 2.13, p = 0.012), and body mass index (β = 0.867, p = 0.022) were independent related factors for C-LSDI. Conclusion This study showed that all HRQOLs demonstrated the varying degree of correlations with C-LSDI, of which the ODI, JOA-29, SRS-22 Function, and SF-36 PCS were most relevant, with moderate strength of associations.Moreover, longer fusion levels, higher BMI, and greater postoperative SVA independently affect C-LSDI after long segmental posterior instrumentation and fusion for DLS.

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