• Kazunori Hayashi, Louis Boissière, Fernando Guevara-Villazón, Daniel Larrieu, Anouar Bourghli, Olivier Gille, Jean-Marc Vital, Ferran Pellisé, Pérez-Grueso Francisco Javier Sánchez FJS Spine Surgery Unit, Hospital Universitario La Paz, Paseo de La Castellana, 261, 28046, Madrid, Spain., Frank Kleinstück, Emre Acaroğlu, Ahmet Alanay, Hiroaki Nakamura, Ibrahim Obeid, and European Spine Study Group, ESSG.
• Spine Surgery Unit 1, Bordeaux University Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux, France. kh_ocg@yahoo.co.jp.
• Eur Spine J. 2020 Jan 1; 29 (1): 63-72.

PurposePreoperative patient self-image (SI) in adult spinal deformity (ASD) is the most relevant factor for surgical decision-making. Postoperative SI has an important role in a patient's satisfaction with surgery. However, few studies are available to describe these variables. The aim was to investigate the factors that correlate with SI before and 2 years after ASD surgery.MethodsThis study was a retrospective review of prospectively collected multicentric data. Patients who underwent ASD surgery with a minimum follow-up of 2 years were enrolled (n = 391). They were divided into high-SI and low-SI groups, both preoperatively and postoperatively, according to SRS-22R SI/appearance subdomain scores at baseline and at 2 years, respectively. Independently related factors for SI were determined using logistic regression analysis.ResultsCrucial factors for SI at baseline were the scores on the SRS-22R function/activity (OR: 2.61), SRS-22R mental health (OR: 2.63) subdomains, and relative spinopelvic alignment (RSA, OR: 0.95). SF-36 MCS (OR: 1.07) at baseline as well as sagittal vertical axis (SVA, OR: 0.99) at 2 years, and complications (OR: 0.44) were independent predictive factors for SI at 2 years. The patients who transitioned from the preoperative low-SI group to the postoperative high-SI group achieved larger global sagittal alignment restoration and had lesser complications than those who did not.ConclusionsMental status and sagittal spinopelvic alignment are key determinants of SI. The results indicate that considering mental status, preventing complications, and global sagittal alignment, restoration is crucial for achieving substantial SI scores after ASD surgery. These slides can be retrieved under Electronic Supplementary Material.

18 keywords...

hide…