Get acquainted with four of the abstract submissions for EUROSPINE 2021 in Vienna, which have been elected as Best of Show and will be presented in the Best of Show and Award papers session
Gain in HRQL after ASD Surgery is maintained between 2 and 5 years’ Follow-Up. Results from A Prospective Multicentre Observational Cohort Study
Presentation by Ferran Pellisé, Alba Vila-Casademunt, Maria Capdevila-Bayo, Susana Núñez-Pereira, Aleix Ruiz-De Villa, Sleiman Haddad, Javier Pizones, Frank Kleinstück, Manuel Ramírez-Valencia, Ibrahim Obeid, Ahmet Alanay, Anne Mannion, ESSG European Spine Study Group
Introduction: Despite the increasing number of surgeries done for Adult Spinal Deformity (ASD), there is a lack of data with more than five years of follow-up. Most studies on ASD have no follow-up beyond two years after surgery and those that do exist are analyses done in small, single-centre cohorts or with considerably low follow-up rates. Emphasis on value-based outcomes and long-term follow-up studies are needed. The main objective of our study was to investigate the durability of ASD surgical outcomes. The secondary objectives were to evaluate predictors of loss to follow-up at five years and to search for predictors of HRQOL at five years postop.
Methods: We included all surgical patients enrolled in an international (5 sites) ASD database with more than 5 years of follow up (operated before March 2015) with at least 2 year follow up data. We analysed the long term (5 years postop) ASD surgical treatment outcomes (radiographic correction and HRQoL) and rates of adverse events.
First of all, predictors of loss to follow-up at 5 years were evaluated to rule out selection bias during subsequent analyses. To do so, different logistic regression models controlling for confounding variables were constructed.
After the analysis on the selection bias for the 5 years of follow up, we assessed 2- and 5-years surgical outcomes: adverse events (complications and reinterventions), HRQL (ODIv2, SF-36v2.0™, SRS-22R) and standing radiographic (coronal and sagittal) parameters.
Complications and reinterventions at 2 and 5 years of follow-up were descriptively compared. Rates of complications were analysed before 2 years and between 2- and 5-years postop dividing them by their impact (minor and major) and by their category (mechanical, medical, infectious and neurological). Rates of reinterventions were also analysed dividing them by the adverse event leading to the reintervention.
HRQOL (ODIv2, SF-36v2.0™, SRS-22R) and radiographic outcomes were analysed between preop-2 years, preop-5 years, 2 years-5years. HRQOL was also evaluated by analysing the proportion of patients reaching published PASS (Patient Acceptable Symptoms State) and MCID (Minimal Clinical Important Difference) using multivariable linear regression, controlling for confounding factors.
We also evaluated predictors (preoperative demographic variables, HRQOL, radiographic characteristics and surgical correction), for HRQOL at 5 years postop using multivariable linear regression, controlling for confounding variables.
Results: There were 1237 surgical patients in the database at the time of the analysis. 361 ([77.8% women; mean (SD) age 52.1 (19.17) y), mean 8.9 fused levels, 16.6% 3CO, 36.3% pelvic fixation, 94.6% posterior only] were operated before March 2015 and were eligible for the present study.
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