Outcomes of Operative Treatment for Adult Cervical Deformity: A Prospective Multicenter Assessment With 1-Year Follow-up

International Spine Study Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients.

OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL.

METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed.

RESULTS: Of 77 ACD patients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomy was performed in 24% of patients. One year following surgery, ACD patients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014).

CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.

Original languageEnglish (US)
Pages (from-to)1031-1039
Number of pages9
JournalNeurosurgery
Volume83
Issue number5
DOIs
StatePublished - Nov 1 2018

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Kyphosis
Neck Pain
Quality of Life
Neck
Pain
Osteotomy
Comorbidity
Cohort Studies
Anxiety
Outcome Assessment (Health Care)
Prospective Studies
Depression
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Outcomes of Operative Treatment for Adult Cervical Deformity : A Prospective Multicenter Assessment With 1-Year Follow-up. / International Spine Study Group.

In: Neurosurgery, Vol. 83, No. 5, 01.11.2018, p. 1031-1039.

Research output: Contribution to journalArticle

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title = "Outcomes of Operative Treatment for Adult Cervical Deformity: A Prospective Multicenter Assessment With 1-Year Follow-up",
abstract = "BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients.OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL.METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed.RESULTS: Of 77 ACD patients, 55 (71{\%}) had 1-yr follow-up (64{\%} women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47{\%}). Diagnoses included cervical sagittal imbalance (56{\%}), cervical kyphosis (55{\%}), proximal junctional kyphosis (7{\%}) and coronal deformity (9{\%}). Posterior fusion was performed in 85{\%} (mean levels = 10), and anterior fusion was performed in 53{\%} (mean levels = 5). Three-column osteotomy was performed in 24{\%} of patients. One year following surgery, ACD patients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014).CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.",
author = "{International Spine Study Group} and Tamir Ailon and Smith, {Justin S.} and Shaffrey, {Christopher I.} and Kim, {Han Jo} and Gregory Mundis and Munish Gupta and Eric Klineberg and Frank Schwab and Virginie Lafage and Renaud Lafage and Peter Passias and Themistocles Protopsaltis and Neuman, {Brian J} and Alan Daniels and Scheer, {Justin K.} and Alex Soroceanu and Robert Hart and Rick Hostin and Douglas Burton and Vedat Deviren and Albert, {Todd J.} and Riew, {K. Daniel} and Shay Bess and Ames, {Christopher P.}",
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T1 - Outcomes of Operative Treatment for Adult Cervical Deformity

T2 - A Prospective Multicenter Assessment With 1-Year Follow-up

AU - International Spine Study Group

AU - Ailon, Tamir

AU - Smith, Justin S.

AU - Shaffrey, Christopher I.

AU - Kim, Han Jo

AU - Mundis, Gregory

AU - Gupta, Munish

AU - Klineberg, Eric

AU - Schwab, Frank

AU - Lafage, Virginie

AU - Lafage, Renaud

AU - Passias, Peter

AU - Protopsaltis, Themistocles

AU - Neuman, Brian J

AU - Daniels, Alan

AU - Scheer, Justin K.

AU - Soroceanu, Alex

AU - Hart, Robert

AU - Hostin, Rick

AU - Burton, Douglas

AU - Deviren, Vedat

AU - Albert, Todd J.

AU - Riew, K. Daniel

AU - Bess, Shay

AU - Ames, Christopher P.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients.OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL.METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed.RESULTS: Of 77 ACD patients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomy was performed in 24% of patients. One year following surgery, ACD patients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014).CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.

AB - BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients.OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL.METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed.RESULTS: Of 77 ACD patients, 55 (71%) had 1-yr follow-up (64% women, mean age of 62 yr, mean Charlson Comorbidity Index of 0.6, previous cervical surgery in 47%). Diagnoses included cervical sagittal imbalance (56%), cervical kyphosis (55%), proximal junctional kyphosis (7%) and coronal deformity (9%). Posterior fusion was performed in 85% (mean levels = 10), and anterior fusion was performed in 53% (mean levels = 5). Three-column osteotomy was performed in 24% of patients. One year following surgery, ACD patients had significant improvement in Neck Disability Index (50.5 to 38.0, P < .001), neck pain numeric rating scale score (6.9 to 4.3, P < .001), EuroQol 5 dimension (EQ-5D) index (0.51 to 0.66, P < .001), and EQ-5D subscores: mobility (1.9 to 1.7, P = .019), usual activities (2.2 to 1.9, P = .007), pain/discomfort (2.4 to 2.1, P < .001), anxiety/depression (1.8 to 1.5, P = .014).CONCLUSION: Based on a prospective multicenter series of ACD patients, surgical treatment provided significant improvement in multiple measures of pain and function, including Neck Disability Index, neck pain numeric rating scale score, and EQ-5D. Further follow-up will be necessary to assess the long-term durability of these improved outcomes.

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