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Stratifying outcome based on the Oswestry Disability Index for operative treatment of adult spinal deformity on patients 60 years of age or older: a multicenter, multi-continental study on Prospective Evaluation of Elderly Deformity Surgery (PEEDS)
- Source :
- Spine Journal, 21, 11, pp. 1775-1783, Spine Journal, 21, 1775-1783
- Publication Year :
- 2021
-
Abstract
- Patients with adult spinal deformity suffer from disease related disability as measured by the Oswestry Disability Index (ODI) for which surgery can result in significant improvements.The purpose of this study was to show the change in overall and individual components of the ODI in patients aged 60 years or older following multi-level spinal deformity surgery.Prospective, multicenter, multi-continental, observational longitudinal cohort study PATIENT SAMPLE: Patients ≥60 years undergoing primary spinal fusion surgery of ≥5 levels for coronal, sagittal or combined deformity.Oswestry Disability Index (ODI) METHODS: : Patients completed the ODI pre-operatively for baseline, then at 10 weeks, 12 months and 24 months post-operatively. ODI scores were grouped into deciles, and change was calculated with numerical score and improvement or worsening was further categorized from baseline as substantial (≥20%), marginal (≥10-20%) or no change (within 10%).Two-hundred nineteen patients met inclusion criteria for the study. The median number of spinal levels fused was 9 [Q1=5.0, Q3=12.0]. Two-year mean (95% CI) ODI improvement was 19.3% (16.7%; 21.9%; p.001) for all age groups, with mean scores improved from a baseline of 46.3% (44.1%; 48.4%) to 41.1% (38.5%; 43.6%) at 10 weeks (p.001), 28.1% (25.6%; 30.6%) at 12 months (p.001), and 27.0% (24.4%; 29.5%) at 24 months (p.001). At 2 years, 45.5% of patients showed 20% or greater improvement in ODI, 23.7% improved between 10% and 20%, 26.3% reported no change (defined as±10% from baseline), 4.5% of patients reported a worsening between 10% to 20%, and none reported worsening greater than 20%. 59.0% of patients were severely disabled (ODI40%) pre-operatively, which decreased to 20.2% at 2 years. Significant improvement was observed across all 10 ODI items at 12 and 24 months. The largest improvements were seen in pain, walking, standing, sex life, social life and traveling.In this prospective, multicenter, multi-continental study of patients 60 years or older undergoing multi-level spinal deformity surgery, almost 70% of patients reported significant improvements in ODI without taking into account surgical indications, techniques or complications. Clear data is presented demonstrating the particular change from baseline for each decile of pre-operative ODI score, for each sub-score, and for each age group.
- Subjects :
- Adult
medicine.medical_specialty
Context (language use)
Scoliosis
Disability Evaluation
All institutes and research themes of the Radboud University Medical Center
Quality of life
medicine
Deformity
Humans
Orthopedics and Sports Medicine
Longitudinal Studies
Aged
Retrospective Studies
business.industry
Infant
medicine.disease
Spine
Oswestry Disability Index
Surgery
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Treatment Outcome
Child, Preschool
Sex life
Coronal plane
Quality of Life
Observational study
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 15299430
- Database :
- OpenAIRE
- Journal :
- Spine Journal, 21, 11, pp. 1775-1783, Spine Journal, 21, 1775-1783
- Accession number :
- edsair.doi.dedup.....2948527022f303d4ad95c768b4f7b0c3