Patient Satisfaction after Adult Spinal Deformity Surgery Does Not Strongly Correlate with Health-Related Quality of Life Scores, Radiographic Parameters or Occurrence of Complications

Kojo K. Hamilton, Christopher Kong, Jayme Hiratzka, Alec G. Contag, Tamir Ailon, Breton Line, Alan Daniels, Justin S S Smith, Peter Passias, Themistocles Protopsaltis, Daniel Sciubba, Douglas Burton, Christopher Shaffrey, Eric Klineberg, Gregory Mundis, Han Jo Kim, Virginie Lafage, Renaud Lafage, Justin Scheer, Oheneba Boachie-AdjeiShay Bess, Robert Hart

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN.: This is a multicenter retrospective review of prospectively collected cases. OBJECTIVE.: Our objective was to evaluate the relationship between patient satisfaction, HRQoL scores, complications, and radiographic measures at 2 years post-operative follow-up. SUMMARY OF BACKGROUND DATA.: For patients receiving operative management for adult spine deformity (ASD), the relationship between health-related quality of life (HRQoL) measures, radiographic parameters, post-operative complications, and self-reported satisfaction remains unclear. METHODS.: Data from 248 patients across 11 centers within the United States who underwent thoracolumbar fusion for ASD and had a minimum of 2 years follow-up was collected. Pre- and post-operative scores were obtained from the Scoliosis Research Society 22-item (SRS-22r), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and the Visual Analogue Scale (VAS). Sagittal vertical axis, coronal C7 plumbline, lumbar lordosis, pelvic tilt, T1 pelvic angle, and the difference between pelvic incidence and lumbar lordosis were assessed using post-operative radiographic films. Satisfaction (SAT) was assessed using the SRS-22r; patients were categorized as highly satisfied (HS) or less satisfied (LS). The correlation between SAT and HRQoL scores, radiographic parameters, and complications was determined. RESULTS.: When compared to LS (n?=?60) patients, HS (n?=?188) patients demonstrated greater improvement in final ODI, SF-36 component scores, SRS-Total, and VAS back scores (p?<?0.05). The correlations between SAT and the final follow-up and 2 year change from baseline values were moderate for MCS, PCS, and ODI or weak for HRQoL scores (p?<?0.0001). The HS and LS groups were equal in pre- or final post-operative radiographic parameters. Occurrence of complications had no effect on satisfaction. CONCLUSION.: Among operatively treated ASD patients, satisfaction was moderately correlated with some HRQoL measures, and not with radiographic changes or post-operative complications. Other factors, such as patient expectations and relationship with the surgeon, may be stronger drivers of patient satisfaction.

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Sep 29 2016

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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    Hamilton, K. K., Kong, C., Hiratzka, J., Contag, A. G., Ailon, T., Line, B., Daniels, A., Smith, J. S. S., Passias, P., Protopsaltis, T., Sciubba, D., Burton, D., Shaffrey, C., Klineberg, E., Mundis, G., Kim, H. J., Lafage, V., Lafage, R., Scheer, J., ... Hart, R. (Accepted/In press). Patient Satisfaction after Adult Spinal Deformity Surgery Does Not Strongly Correlate with Health-Related Quality of Life Scores, Radiographic Parameters or Occurrence of Complications. Spine. https://doi.org/10.1097/BRS.0000000000001921