Norton Leatherman Spine Center, 210 East Gray Street, Louisville, KY.
Inova Loudoun Hospital, Lansdowne, VA.
Spine (Phila Pa 1976). 2021 Jun 15;46(12):822-827. doi: 10.1097/BRS.0000000000003897.
Longitudinal cohort.
The aim of this study was to examine the relationship between patient satisfaction, patient-reported outcome measures (PROMs) and radiographic parameters in adult spine deformity (ASD) patients undergoing three-column osteotomies (3CO).
Identifying factors that influence patient satisfaction in ASD is important. Evidence suggests Scoliosis Research Society-22R (SRS-22R) Self-Image domain correlates with patient satisfaction in patients with ASD.
This is a retrospective review of ASD patients enrolled in a prospective, multicenter database undergoing a 3CO with complete SRS-22R pre-op and minimum 2-years postop. Spearman correlations were used to evaluate associations between the 2-year SRS Satisfaction score and changes in SRS-22R domain scores, Oswestry Disability Index (ODI), and radiographic parameters.
Of 135 patients eligible for 2-year follow-up, 98 patients (73%) had complete pre- and 2-year postop data. The cohort was mostly female (69%) with mean BMI of 29.7 kg/m2 and age of 61.0 years. Mean levels fused was 12.9 with estimated blood loss of 2695 cc and OR time of 407 minutes; 27% were revision surgeries. There was a statistically significant improvement between pre- and 2-year post-op PROMs and all radiographic parameters except Coronal Vertical Axis. The majority of patients had an SRS Satisfaction score of ≥3.0 (90%) or ≥4.0 (68%), consistent with a moderate ceiling effect. Correlations of patient satisfaction was significant for Pain (0.43, P < 0.001), Activity (0.39, P < 0.001), Mental (0.38, P = 0.001) Self-Image (0.52, P < 0.001). ODI and Short-Form-36 Physical component summary had a moderate correlation as well, with mental component summary being weak. There was no statistically significant correlation between any radiographic or operative parameters and patient satisfaction.
There was statistically significant improvement in all PROMs and radiographic parameters, except coronal vertical axis at 2 years in ASD patients undergoing 3CO. Improvement in SRS Self-Image domain has the strongest correlation with patient satisfaction.Level of Evidence: 3.
纵向队列研究。
本研究旨在探讨行三柱截骨术（3CO）的成人脊柱畸形（ASD）患者的患者满意度、患者报告的结局测量（PROMs）和影像学参数之间的关系。
确定影响 ASD 患者满意度的因素很重要。有证据表明，脊柱畸形研究学会 22 修订版（SRS-22R）自我形象域与 ASD 患者的患者满意度相关。
这是一项对前瞻性多中心数据库中接受 3CO 的 ASD 患者进行的回顾性研究，所有患者均有完整的术前 SRS-22R 和至少 2 年的术后随访。采用 Spearman 相关分析评估 2 年 SRS 满意度评分与 SRS-22R 各领域评分、Oswestry 功能障碍指数（ODI）和影像学参数变化之间的相关性。
在符合 2 年随访条件的 135 例患者中，98 例（73%）患者具有完整的术前和术后 2 年数据。该队列中女性占比 69%，平均 BMI 为 29.7kg/m2，年龄为 61.0 岁。平均融合节段为 12.9 个，估计失血量为 2695cc，手术时间为 407 分钟；27%为翻修手术。与术前相比，所有 PROMs 和影像学参数（除冠状垂直轴外）在术后 2 年均有统计学显著改善。大多数患者的 SRS 满意度评分为≥3.0（90%）或≥4.0（68%），表明存在中度天花板效应。疼痛（0.43，P<0.001）、活动（0.39，P<0.001）、精神（0.38，P=0.001）、自我形象（0.52，P<0.001）等 PROMs 与患者满意度呈显著相关。ODI 和 36 项简短健康调查问卷的生理成分综合评分也有中度相关性，而精神成分综合评分相关性较弱。患者满意度与任何影像学或手术参数均无统计学显著相关性。
行 3CO 的 ASD 患者在术后 2 年时，所有 PROMs 和影像学参数（除冠状垂直轴外）均有统计学显著改善。SRS 自我形象域的改善与患者满意度相关性最强。
3 级。
