Sistema de Salut de Catalunya
Institut Català de la Salut
[Baroncini A] Department of Orthopaedics and Trauma Surgery, RWTH Uniklinik Aachen, Aachen, Germany. [Frechon P] Spine Surgery Unit 1, Bordeaux University Pellegrin Hospital, Bordeaux, France. Department of Neurosurgery, Caen University Hospital, Caen, France. [Bourghli A] Spine Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. [Smith JS] Department of Neurological Surgery, University of Virginia Health System, Charlottesville, USA. [Larrieu D] Spine Surgery Unit 1, Bordeaux University Pellegrin Hospital, Bordeaux, France. [Pellisé F] Unitat de Recerca de la Columna Vertebral, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-10-18T07:33:07Z
2023-10-18T07:33:07Z
2023-10
Adult spinal deformity; Coronal alignment; Mechanical complications
Deformidad espinal del adulto; Alineación coronal; Complicaciones mecánicas
Deformitat espinal de l'adult; Alineació coronal; Complicacions mecàniques
Purpose Coronal balance is a major factor impacting the surgical outcomes in adult spinal deformity (ASD). The Obeid coronal malalignment (O-CM) classification has been proposed to improve the coronal alignment in ASD surgery. Aim of this study was to investigate whether a postoperative CM < 20 mm and adherence to the O-CM classification could improve surgical outcomes and decrease the rate of mechanical failure in a cohort of ASD patients. Methods Multicenter retrospective analysis of prospectively collected data on all ASD patients who underwent surgical management and had a preoperative CM > 20 mm and a 2-year follow-up. Patients were divided in two groups according to whether or not surgery had been performed in adherence to the guidelines of the O-CM classification and according to whether or not the residual CM was < 20 mm. The outcomes of interest were radiographic data, rate of mechanical complications and Patient-Reported Outcome Measures. Results At 2 years, adherence to the O-CM classification led to a lower rate of mechanical complications (40 vs. 60%). A coronal correction of the CM < 20 mm allowed for a significant improvement in SRS-22 and SF-36 scores and was associated with a 3.5 times greater odd of achieving the minimal clinical important difference for the SRS-22. Conclusion Adherence to the O-CM classification could reduce the risk of mechanic complications 2 years after ASD surgery. Patients with a residual CM < 20 mm showed better functional outcomes and a 3.5 times greater odd of achieving the MCID for the SRS-22 score.
Open Access funding enabled and organized by Projekt DEAL. None.
Article
Published version
English
Columna vertebral - Malformacions - Cirurgia; Cirurgia - Complicacions; DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures; Other subheadings::Other subheadings::Other subheadings::/surgery; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications; ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral; Otros calificadores::Otros calificadores::Otros calificadores::/cirugía; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
Springer
European Spine Journal;32
https://doi.org/10.1007/s00586-023-07831-0
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
