Changes in Health Utility, Disability, and Health-Related Quality of Life in Patients After Spinal Fusion
STUDY DESIGN Prospective longitudinal database study. OBJECTIVE To evaluate changes in health utility, disability, and health-related quality of life (HRQOL) in patients undergoing spinal fusion. SUMMARY OF BACKGROUND DATA Recently, measuring disability, HRQOL, and health utility has become important when defining the value of surgical interventions. METHODS Data of spinal fusion patients from a prospective longitudinal database were analyzed. Health utility was captured by SF-6D (six dimensional health state classification from the 36-dimensional Short Form Health Survey) score, disability by Oswestry Disability Index, and HRQOL by the 36-Item Short Form Health Survey. The changes in these…
Long-term clinical and radiographic outcomes and patient satisfaction after adult spinal deformity correction
Background and Aims: Adult spinal deformity surgery has increased with the aging population and modern surgical approaches, although it has high complication and reoperation rates. The permanence of radiographic correction, mechanical complications, predictive factors for poor patient-reported outcomes, and patient satisfaction were analyzed. Material and Methods: A total of 79 adult patients were retrospectively analyzed at baseline and 1–9 years after adult spinal deformity correction between 2007 and 2016. Patient-reported outcomes (Oswestry Disability Index, visual analog scale, and Scoliosis Research Society–30 scores), changes in radiographic alignment, indications for reoperation, pr…
Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients
Purpose: Interleukin 6 (IL-6) and the acute phase C-reactive protein (CRP) blood concentrations after lumbar spine fusion may be affected by age. The purpose of this prospective observational study was to assess postoperative serum levels of pro-inflammatory IL-6 and CRP after instrumented lumbar spine fusion surgery. We hypothesized that older patients would have increased levels of IL-6 and CRP after surgery. Methods: IL-6 and high-sensitive CRP biochemical marker levels were measured before instrumented spinal fusion, and postoperatively at 1 and 3 days, 6 weeks, and 3 months. The 49 patients in this sample were divided into two groups: age ≤ 60 years (n = 23) and age > 60 years (n = 26)…
DEPS-testin luotettavuus ja pätevyys aikuisilla selkäpotilailla
The Depression Scale (DEPS) is a patient-reported outcome instrument developed to recognize depressive symptoms. This study measured the psychometric properties of the DEPS among patients with degenerative spinal disease. Altogether 637 patients were included in the analysis. Main research question was whether the DEPS would meet pertinent psychometric criteria for reliability and validity. The results of analyses supported the DEPS instrument as a reliable and valid test to measure depressive symptoms among adult patients with spinal disease fulfilling the psychometric criteria. nonPeerReviewed
Scoliosis Research Society (SRS-30) kyselykaavakkeen pätevyys selkä- ja alaraajakipuisilla aikuispotilailla
Scoliosis Research Society questionnaire version 30 (SRS-30) has originally been developed to measure disability and health related quality of life in patients with adolescent idiopathic scoliosis but it has proven valid also in adults with degenerative spinal disease. Degenerative spine disease has many phases and manifestations including disc degeneration, spondylarthrosis, spondylolistheses and compromise to neural tissue. The aim of this study was to test whether the SRS-30 questionnaire is valid in adults with different sources of pain: local back pain, radicular pain or their combination. Structural analysis of the SRS-30 and comparison with RAND-36 and ODI was performed. The deformit…
Psychometric Properties of the Scoliosis Research Society Questionnaire (Version 22r) Domains Among Adults With Spinal Deformity : A Rasch Measurement Theory Analysis
Objective: Adults with degenerative spinal deformity (ASD) have lower health-related quality of life (HRQL) compared to the general population. Applying Rasch Measurement Theory (RMT), this study tested the revised Scoliosis Research Society-22 (SRS-22r) HRQL instrument among symptomatic adult patients with degenerative spinal disorders and varying degrees of ASD. Methods: SRS-22r data from 637 outpatient spine clinic patients with degenerative spine conditions were investigated for unidimensionality, item/scale fit, differential item functioning (DIF), scale coverage/targeting, and person separation index (PSI) using RMT. Results: Unidimensionality of the SRS-22r was not supported for eith…
Effectiveness of a 12-month home-based exercise program on trunk muscle strength and spine function after lumbar spine fusion surgery:a randomized controlled trial
Purpose: The effectiveness of a 12-month home-exercise program on trunk muscle strength after lumbar spine fusion surgery was evaluated. Materials and methods: Three months postoperatively, 98 patients were randomized either to the exercise group (EG), with a progressive 12-month home-based exercise program, or to usual care group (UCG), with one guidance session for light home-exercises. Maximal trunk muscle strength was measured by a strain-gauge dynamometer and trunk extensor endurance was measured by Biering-Sørensen’s test at baseline and after the intervention. Results: The mean change in extension strength during the intervention was 75 N in EG and 58 N in UCG. Flexion strength impro…
Disability, Health-Related Quality of Life and Mortality in Lumbar Spine Fusion Patients : A 5-Year Follow-Up and Comparison With a Population Sample
Study Design: Prospective follow-up study. Objectives: We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population. Methods: 523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort. Results: The preoperative ODI in the patients was 46 (SD 16), and the change …
Reliability and Validity Study of the Finnish Adaptation of Scoliosis Research Society Questionnaire Version SRS-30
Study design A prospective clinical study to test and adapt a Finnish version of the Scoliosis Research Society 30 (SRS-30) questionnaire. Objective The aim of this study was to perform cross-cultural adaptation and evaluate the validity of the adapted Finnish version of the SRS-30 questionnaire. Summary of background data The SRS-30 questionnaire has proved to be a valid instrument in evaluating health-related quality of life (HRQoL) in adolescent and adult population with spine deformities in the United States. Multinational availability requires cross-cultural and linguistic adaptation and validation of the instrument. Methods The SRS-30 was translated into Finnish using accepted methods…
Spinopelvic changes based on the simplified SRS-Schwab adult spinal deformity classification: relationships with disability and health-related quality of life in adult patients with prolonged degenerative spinal disorders
Study design Cross-sectional, observational study. Objective To study the occurrence of sagittal malalignment, the adaptability of a simplified sagittal modifiers grading of the Scoliosis Research Society (SRS)-Schwab adult spinal deformity (ASD) classification, and the deformity-specific SRS questionnaire version 30 (SRS-30) in an unselected adult cohort with symptomatic degenerative spinal disorders. Summary of background data The sagittal modifiers of the SRS-Schwab ASD classification correlate with health-related quality of life (HRQoL) measures in patients with ASD. The deformities and disabilities caused by sagittal malalignment in patients with common degenerative spinal disorders of…
Aikuisten selän ryhtivirheet : leikkaushoidon pitkäaikaistulokset K-SKS:ssa
Adult patients with degenerative deformities (ASD) benefit surgical treatment when exercise and pain medication seize to control their symptoms. Disability and clinical symptoms are stronger drivers against surgical treatment of ASD than radiographic changes. We present the results of 79 adult patients’ corrective surgery for degenerative spinal deformity of after 1-10 year follow-up. PI-LL (pelvic incidence minus lumbar lordosis) mismatch remained stable after correction during follow-up. Global sagittal balance indicated by sagittal vertical axis (SVA) and T1 pelvic angle (TPA) started deteriorating after 2.5 years postoperatively. 26 (32.9%) patients required reoperation. 77.1% of the pa…
Rasch validation of the Depression Scale among patients with low back pain.
BACKGROUND: The Depression Scale (DEPS) is a commonly used screening tool for major depression in studies investigating low back pain, yet it has not been validated for patients with back-specific problems. OBJECTIVE: To assess the psychometric properties of the DEPS in patients with degenerative spinal disease. METHODS: Six hundred and thirty-seven patients with a degenerative spinal disease completed the DEPS instrument. The Rasch Measurement Theory was applied to analyze the measurement properties of the DEPS. The main hypothesis-driven approach was whether the DEPS would meet relevant psychometric criteria for assessing depressive symptoms among patients with degenerative spinal disease…
Trunk Muscle Strength After Lumbar Spine Fusion: A 12-Month Follow-up.
Objective: The aim of this study was to investigate changes in trunk muscle strength 12 months after lumbar spine fusion (LSF) compared to preoperative strength. Methods: A total of 194 patients (mean ± standard deviation [SD] age, 61 ± 21 years) who underwent LSF participated in this prospective longitudinal study. Physical measurements of the participants were made before surgery and 12 months postoperatively. Isometric trunk extension and flexion strength was measured using a strain-gauge dynamometer in the standing position. Strength changes were calculated. Regression analysis was performed to explore which factors predicted strength levels at 12 months postoperatively. Results: The pr…
Disability, Health-Related Quality of Life and Mortality in Lumbar Spine Fusion Patients—A 5-Year Follow-Up and Comparison With a Population Sample
Study Design: Prospective follow-up study. Objectives: We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population. Methods: 523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort. Results: The preoperative ODI in the patients was 46 (SD 16), and the change …
Further validation of the Scoliosis Research Society (SRS-30) questionnaire among adult patients with degenerative spinal disorder.
Purpose The Scoliosis Research Society (SRS-30) questionnaire proved valid in measuring health-related quality of life (HRQoL) in adult patients with spinal deformity or degenerative disease. This study further assesses the validity of the SRS-30 by comparing its results with other HRQoL instruments, such as Oswestry disability index (ODI) and the RAND-36, among unselected adult patients with degenerative spinal disorder. Materials and methods 628 consecutive patients completed the SRS-30, the ODI, the pain visual analog scale (VAS), and RAND-36 questionnaires. Using a 9 mm minimal important difference threshold of the VAS, patients were divided into three groups of symptom location: back p…
Assessment of Construct Validity of the Oswestry Disability Index and the Scoliosis Research Society–30 Questionnaire (SRS-30) in Patients With Degenerative Spinal Disease
Observational cohort study.To measure and compare the structural validity of the Oswestry Disability Index (ODI) and the Scoliosis Research Society-30 (SRS-30) questionnaire in an adult population with prolonged degenerative thoracolumbar disease.The ODI and the SRS-30 are commonly used patient-reported outcome instruments to assess back-specific disability and symptoms related to scoliosis. Still, these instruments have not been validated for degenerative spinal disease with different stages of deformity.Altogether, 637 consecutive adult patients with degenerative spinal pathologies were included. The patients completed the ODI (version 2.0), the 23 preoperative items of the SRS-30, a gene…
Intra- and Interrater Reliability of Sagittal Spinopelvic Parameters on Full-Spine Radiographs in Adults With Symptomatic Spinal Disorders
Background/Aims To evaluate the intra- and interrater reliability (I-IR) of sagittal spinopelvic parameters from digital full-spine plain radiographs with basic software tools in an unselected adult population with degenerative spinal complaints who were evaluated for surgery. Methods Forty-nine adult full-spine digital radiographs were measured twice by 3 independent observers, including an experienced spine surgeon, an experienced radiologist, and a resident orthopedic surgeon. Clinical picture archiving and communication system workstations and software tools were used and landmarks were set manually. The I-IR of the sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), …
Effect of Obesity and Being Overweight on Disability and Pain After Lumbar Fusion: An Analysis of 805 Patients.
STUDY DESIGN Prospective follow-up study. OBJECTIVE To investigate the influence of obesity and being overweight on disability and pain of patients undergoing lumbar spinal fusion. SUMMARY OF BACKGROUND DATA Although spinal fusion surgery has been shown to relieve symptoms in several spinal disorders, the influence of obesity on the results remains controversial. METHODS Since January 1, 2008, all patients undergoing lumbar fusion in two hospitals have been invited to participate in a prospective follow-up database. At the end of 2014, the preoperative and 1-year follow-up data of 805 patients were available. Disability was evaluated using the Oswestry Disability Index and back and leg pain…