Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery.

Diebo, Bassel G; Alsoof, Daniel; Lafage, Renaud; Daher, Mohammad; Balmaceno-Criss, Mariah; Passias, Peter G; Ames, Christopher P; Shaffrey, Christopher I; Burton, Douglas C; Deviren, Vedat; Line, Breton G; Soroceanu, Alex; Hamilton, David Kojo; Klineberg, Eric O; Mundis, Gregory M; Kim, Han Jo; Gum, Jeffrey L; Smith, Justin S; Uribe, Juan S; Kebaish, Khaled M; Gupta, Munish C; Nunley, Pierce D; Eastlack, Robert K; Hostin, Richard; Protopsaltis, Themistocles S; Lenke, Lawrence G; Hart, Robert A; Schwab, Frank J; Bess, Shay; Lafage, Virginie; Daniels, Alan H

Diebo, Bassel G; Alsoof, Daniel; Lafage, Renaud; Daher, Mohammad; Balmaceno-Criss, Mariah; Passias, Peter G; Ames, Christopher P; Shaffrey, Christopher I; Burton, Douglas C; Deviren, Vedat; Line, Breton G; Soroceanu, Alex; Hamilton, David Kojo; Klineberg, Eric O; Mundis, Gregory M; Kim, Han Jo; Gum, Jeffrey L; Smith, Justin S; Uribe, Juan S; Kebaish, Khaled M; Gupta, Munish C; Nunley, Pierce D; Eastlack, Robert K; Hostin, Richard; Protopsaltis, Themistocles S; Lenke, Lawrence G; Hart, Robert A; Schwab, Frank J; Bess, Shay; Lafage, Virginie; Daniels, Alan H.

Afiliación

Diebo BG; Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA.
Alsoof D; Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA.
Lafage R; Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA.
Daher M; Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA.
Balmaceno-Criss M; Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA.
Passias PG; Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY 10016, USA.
Ames CP; Department of Neurosurgery, University of California, San Francisco, CA 94115, USA.
Shaffrey CI; Department of Neurosurgery, Duke Spine Division, Durham, NC 27708, USA.
Burton DC; Department of Orthopaedic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA.
Deviren V; Department of Neurosurgery, University of California, San Francisco, CA 94115, USA.
Line BG; Denver International Spine Center, Denver, CO 80218, USA.
Soroceanu A; Department of Orthopedic Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada.
Hamilton DK; Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Klineberg EO; Department of Orthopaedic Surgery, University of California, 1 Shields Ave., Davis, CA 95616, USA.
Mundis GM; San Diego Spine, La Jolla, CA 92037, USA.
Kim HJ; Hospital for Special Surgery, New York, NY 10021, USA.
Gum JL; Leatherman Spine Center, Louisville, KY 40202, USA.
Smith JS; Department of Neurosurgery, University of Virginia, Charlottesville, VA 22903, USA.
Uribe JS; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Kebaish KM; Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA.
Gupta MC; Department of Orthopedics, Washington University in St Louis, St. Louis, MO 63110, USA.
Nunley PD; Spine Institute of Louisiana, Shreveport, LA 71101, USA.
Eastlack RK; San Diego Spine, La Jolla, CA 92037, USA.
Hostin R; Department of Orthopaedic Surgery, Baylor Scoliosis Center, 4708 Alliance Blvd #800, Plano, TX 75093, USA.
Protopsaltis TS; Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY 10016, USA.
Lenke LG; Department of Orthopedic Surgery, Columbia University Medical Center, The Spine Hospital at New York Presbyterian, New York, NY 10032, USA.
Hart RA; Swedish Neuroscience Institute, Seattle, WA 98027, USA.
Schwab FJ; Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA.
Bess S; Denver International Spine Center, Denver, CO 80218, USA.
Lafage V; Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA.
Daniels AH; Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA.

J Clin Med ; 13(8)2024 Apr 11.

Article en En | MEDLINE | ID: mdl-38673475

ABSTRACT

ABSTRACT

Background:

The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery.

Methods:

ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence-lumbar lordosis (PI-LL), and surgical invasiveness score.

Results:

In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (-1.2 vs. -3.6°, p = 0.039) for a comparable PI-LL correction (-11.9 vs. -15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years.