gms | German Medical Science

Objectives: Traditionally degree of correction in degenerative scoliosis has thought to have been associated with improved patient reported outcomes. However, little is known about the impact of radiographic measurements as well as predicting factors. This study aimed to look at the correlation of patient reported outcomes and the degree of correction for surgery on degenerative scoliosis (DS).

Methods: A retrospective study was conducted using prospective data from the Australian Spine Registry. The DS cohort consisted of operative deformity in patients greater than 40 years of age. The Oswestry Disability Index (ODI) as well as EQ-5D general health VAS were assessed before surgery, then after 6, 12 and 24 months. All pre- and post-operative whole spine x-rays were analysed measuring pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, hip occipital angle (HOA), sagittal vertical axis (SVA), thoracic and lumbar cobb angles, coronal list, and number of fusion levels. A Pearson correlation test was performed analysing the predictors of patient satisfaction against the change in ODI score after 24 months.

Results and Conclusion: A total of 48 patients met the inclusion criteria between 2018 and 2021. The mean age of patients was 61.3±2.4years. For PROMs the preoperative ODI score was 39.6±5.5% and the change after 24 months was -20.3±6.3%. A greater ODI score improvement was associated with a higher HOA (r=-0.469, p=0.014), A lower preoperative lumbar Cobb angle (r=0.497, p=0.008) and a lower preoperative thoracic Cobb angle (r=0.383, p=0.049). Another major predictor was a higher preoperative ODI score (r=-0.573, p=0.001). For postoperative measurements, the outcome mostly correlated with change in HOA (r=0.488, p=0.013), where as only a positive tendency was observed for change in SVA (r=-0.362, p=0.076) as well as more levels fused (r=-0.359, p=0.056).

The ODI score was the most sensitive measurement in patients undergoing degenerative scoliosis surgery. The ODI improvement is greater in patients with a corrected HOA and in patients with a higher preoperative disability.