TY - JOUR
T1 - Outcomes of Operative Treatment for Adult Cervical Deformity
T2 - A Prospective Multicenter Assessment with 1-Year Follow-up
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
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.
N1 - Publisher Copyright:
© 2017 by the Congress of Neurological Surgeons.
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 osteotomywas performed in 24%of patients.One year following surgery,ACDpatients 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 osteotomywas performed in 24%of patients.One year following surgery,ACDpatients 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.
KW - Cervical deformity
KW - Outcomes
KW - Quality of life
KW - Spinal deformity
KW - Surgery
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U2 - 10.1093/neuros/nyx574
DO - 10.1093/neuros/nyx574
M3 - Article
C2 - 29281107
AN - SCOPUS:85053566960
SN - 0148-396X
VL - 83
SP - 1031
EP - 1039
JO - Clinical neurosurgery
JF - Clinical neurosurgery
IS - 5
ER -