Focusing on the amount of immediate changes in spinopelvic radiographic parameters to predict the amount of mid-term improvement of quality of life in adult degenerative scoliosis patients with surgery

摘要

Introduction Surgery is still an effective treatment option for adult degenerative scoliosis (ADS), but how to predict patients' significant amount of the improvement in quality of life remains unclear. The previous studies included an inhomogeneous population. This study aimed to report the results about concentrating on the amount of immediate changes in spinopelvic radiographic parameters to predict the amount of mid-term improvement in quality of life in ADS patients. Materials and methods Pre-operative and immediately post-operative radiographic parameters included Cobb angle, coronal vertical axis (CVA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI) and LL/PI matching (PI-LL). Quality of life scores were evaluated pre-operatively and at the final follow-up using Oswestry Disability Index (ODI) and visual analogue scale (VAS). The amount of immediate changes in spinopelvic radiographic parameters (Delta) and the amount of mid-term improvement in quality of life (Delta) were defined, respectively. Results Patients showed significant change in radiographic parameters, ODI and VAS pre- and post-surgery, except CVA and PI. Univariate analysis showed a significant correlation between Delta TK, Delta LL, Delta CVA and the amount of mid-term improvement in quality of life, but multivariate analysis did not get a significant result. Univariate and multivariate analyses showed that Delta SVA was still a significant predictor of Delta VAS and Delta ODI. The changes in the other radiographic parameters were not significant. The equations were developed by linear regression: Delta ODI = 0.162 x Delta SVA - 21.592, Delta VAS = 0.034 x Delta SVA - 2.828. In the ROC curve for Delta SVA in the detection of a strong Delta ODI or Delta VAS, the cut-off value of Delta SVA was - 19.855 mm and - 15.405 mm, respectively. Conclusions This study shows that Delta SVA can predict the amount of mid-term improvement in quality of life in ADS patients. The changes in the other radiographic parameters were not significant. Two equations were yielded to estimate Delta ODI and Delta VAS. Delta SVA has respective cut-off value to predict Delta ODI and Delta VAS.