Carreon Leah Y, Kelly Michael P, Crawford Charles H, Baldus Christine R, Glassman Steven D, Shaffrey Christopher I, Bridwell Keith H
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
Department of Orthopaedic Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8233, St. Louis, MO 63110, USA.
Spine Deform. 2018 Jan;6(1):79-83. doi: 10.1016/j.jspd.2017.05.006.
Longitudinal cohort.
To determine if the minimum clinically important difference (MCID) and substantial clinical benefit (SCB) thresholds for the Scoliosis Research Society-22R (SRS22R) domains in patients with degenerative lumbar scoliosis are similar to those in patients with adult spinal deformity (ASD) with fusions extending into the thoracic spine.
The MCID and SCB thresholds for the SRS22R domains in patients with ASD and adolescent idiopathic scoliosis have been reported.
Patients enrolled in the NIH-sponsored Adult Symptomatic Lumbar Scoliosis (ASLS) trial who underwent surgery and completed the SRS22R preoperative and the SRS30 one-year postoperative were identified. One-year postoperative answers to the last eight questions of the SRS30 were used as anchors to determine the MCID and SCB for the Pain, Appearance, and Activity domains, and the Subscore and Total score using receiver operating characteristic (ROC) curve analysis.
The sample population consisted of 147 patients. A total of 132 (89%) were females with a mean age of 59.4 years. There was a statistically significant improvement in all SRS22R scores from preoperative to one-year postoperative. There was also a statistically significant difference in domain scores among the different responses to the anchors. According to the ROC analysis, MCID was 1.17 for Appearance, 0.40 for Activity, 0.60 for Pain, 0.53 for Subscore, and 0.77 for Total; and SCB was 1.67 for Appearance, 0.60 for Activity, 0.62 for Subscore, and 1.11 for Total score. These are similar to previous reports of MCID and SCB thresholds for ASD patients who underwent fusion to the thoracic spine.
The MCID and SCB thresholds for the SRS22R domains in patients with adult symptomatic lumbar scoliosis are very similar to the threshold values previously reported for adult deformity patients.
Level II.
纵向队列研究。
确定退行性腰椎侧弯患者中脊柱侧弯研究学会-22R（SRS22R）各领域的最小临床重要差异（MCID）和显著临床获益（SCB）阈值是否与融合延伸至胸椎的成人脊柱畸形（ASD）患者相似。
已报道了ASD患者和青少年特发性脊柱侧弯患者中SRS22R各领域的MCID和SCB阈值。
确定参加美国国立卫生研究院资助的成人症状性腰椎侧弯（ASLS）试验且接受手术并完成术前SRS22R和术后一年SRS30评估的患者。将SRS30最后八个问题的术后一年答案用作锚定指标，采用受试者操作特征（ROC）曲线分析来确定疼痛、外观和活动领域以及子评分和总分的MCID和SCB。
样本人群包括147例患者。其中132例（89%）为女性，平均年龄59.4岁。从术前到术后一年，所有SRS22R评分均有统计学显著改善。对锚定指标的不同回答之间，各领域评分也存在统计学显著差异。根据ROC分析，外观领域的MCID为1.17，活动领域为0.40，疼痛领域为0.60，子评分为0.53，总分为0.77；外观领域的SCB为1.67，活动领域为0.60，子评分为0.62，总分为1.11。这些与先前报道的接受胸椎融合手术的ASD患者的MCID和SCB阈值相似。
成人症状性腰椎侧弯患者中SRS22R各领域的MCID和SCB阈值与先前报道的成人脊柱畸形患者的阈值非常相似。
二级。
