Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery
Background: Recent studies have evaluated the correlation of health-related quality of life (HRQL) scores with radiographic parameters. This relationship may provide insight into the connection of patient-reported disability and disease burden caused by cervical diagnoses. Purpose: To evaluate the a...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=62;epage=66;aulast=Passias |
| _version_ | 1811342484062601216 |
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| author | Peter Gust Passias Katherine E Pierce Bailey Imbo Lara Passfall Oscar Krol Rachel Joujon-Roche Tyler Williamson Kevin Moattari Peter Tretiakov Ammar Adenwalla Irene Chern Haddy Alas Cole A Bortz Avery E Brown Shaleen Vira Bassel G Diebo Daniel M Sciubba Renaud Lafage Virginie Lafage |
| author_facet | Peter Gust Passias Katherine E Pierce Bailey Imbo Lara Passfall Oscar Krol Rachel Joujon-Roche Tyler Williamson Kevin Moattari Peter Tretiakov Ammar Adenwalla Irene Chern Haddy Alas Cole A Bortz Avery E Brown Shaleen Vira Bassel G Diebo Daniel M Sciubba Renaud Lafage Virginie Lafage |
| author_sort | Peter Gust Passias |
| collection | DOAJ |
| description | Background: Recent studies have evaluated the correlation of health-related quality of life (HRQL) scores with radiographic parameters. This relationship may provide insight into the connection of patient-reported disability and disease burden caused by cervical diagnoses.
Purpose: To evaluate the association between spinopelvic sagittal parameters and HRQLs in patients with primary cervical diagnoses.
Methods: Patients ≥18 years meeting criteria for primary cervical diagnoses. Cervical radiographic parameters assessed cervical sagittal vertical axis, TS-CL, chin-to-brow vertical angle, C2-T3, CL, C2 Slope, McGregor's slope. Global radiographic alignment parameters assessed PT, SVA, PI-LL, T1 Slope. Pearson correlations were run for all combinations at baseline (BL) and 1 year (1Y) for continuous BL and 1Y modified Japanese Orthopaedic Association scale (mJOA) scores, as well as decline or improvement in those HRQLs at 1Y. Multiple linear regression models were constructed to investigate BL and 1Y alignment parameters as independent variables.
Results: Ninety patients included 55.6 ± 9.6 years, 52% female, 30.7 ± 7kg/m2. By approach, 14.3% of patients underwent procedures by anterior approach, 56% posterior, and 30% had combined approaches. Average anterior levels fused: 3.6, posterior: 4.8, and mean total number of levels fused: 4.5. Mean operative time for the cohort was 902.5 minutes with an average estimated blood loss of 830 ccs. The mean BL neck disability index (NDI) score was 56.5 and a mJOA of 12.81. While BL NDI score correlated with gender (P = 0.050), it did not correlate with BL global or cervical radiographic factors. An increased NDI score at 1Y postoperatively correlated with BL body mass index (P = 0.026). A decreased NDI score was associated with 1Y T12-S1 angle (P = 0.009) and 1Y T10 L2 angle (P = 0.013). Overall, BL mJOA score correlated with the BL radiographic factors of T1 slope (P = 0.005), cervical lordosis (P = 0.001), C2-T3 (P = 0.008), C2 sacral slope (P = 0.050), SVA (P = 0.010), and CL Apex (P = 0.043), as well as gender (P = 0.050). Linear regression modeling for the prior independent variables found a significance of P = 0.046 and an R2 of 0.367. Year 1 mJOA scores correlated with 1Y values for maximum kyphosis (P = 0.043) and TS-CL (P = 0.010). At 1Y, a smaller mJOA score correlated with BL S1 sacral slope (P = 0.014), pelvic incidence (P = 0.009), L1-S1 (P = 0.012), T12-S1 (P = 0.008). The linear regression model for those 4 variables demonstrated an R2 of 0.169 and a P = 0.005. An increased mJOA score correlated with PI-LL difference at 1Y (P = 0.012), L1-S1 difference (P = 0.036), T12-S1 difference (0.006), maximum lordosis (P = 0.026), T9-PA difference (P = 0.010), and difference of T4-PA (P = 0.008).
Conclusions: While the impact of preoperative sagittal and cervical parameters on mJOA was strong, the BL radiographic factors did not impact NDI scores. PostOp HRQL was significantly associated with sagittal parameters for mJOA (both worsening and improvement) and NDI scores (improvement). When cervical surgery has been indicated, radiographic alignment is important for postoperative HRQL. |
| first_indexed | 2024-04-13T19:11:53Z |
| format | Article |
| id | doaj.art-df267db9180a4695b4d175c57de0315c |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-04-13T19:11:53Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-df267db9180a4695b4d175c57de0315c2022-12-22T02:33:50ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372022-01-01131626610.4103/jcvjs.jcvjs_104_21Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgeryPeter Gust PassiasKatherine E PierceBailey ImboLara PassfallOscar KrolRachel Joujon-RocheTyler WilliamsonKevin MoattariPeter TretiakovAmmar AdenwallaIrene ChernHaddy AlasCole A BortzAvery E BrownShaleen ViraBassel G DieboDaniel M SciubbaRenaud LafageVirginie LafageBackground: Recent studies have evaluated the correlation of health-related quality of life (HRQL) scores with radiographic parameters. This relationship may provide insight into the connection of patient-reported disability and disease burden caused by cervical diagnoses. Purpose: To evaluate the association between spinopelvic sagittal parameters and HRQLs in patients with primary cervical diagnoses. Methods: Patients ≥18 years meeting criteria for primary cervical diagnoses. Cervical radiographic parameters assessed cervical sagittal vertical axis, TS-CL, chin-to-brow vertical angle, C2-T3, CL, C2 Slope, McGregor's slope. Global radiographic alignment parameters assessed PT, SVA, PI-LL, T1 Slope. Pearson correlations were run for all combinations at baseline (BL) and 1 year (1Y) for continuous BL and 1Y modified Japanese Orthopaedic Association scale (mJOA) scores, as well as decline or improvement in those HRQLs at 1Y. Multiple linear regression models were constructed to investigate BL and 1Y alignment parameters as independent variables. Results: Ninety patients included 55.6 ± 9.6 years, 52% female, 30.7 ± 7kg/m2. By approach, 14.3% of patients underwent procedures by anterior approach, 56% posterior, and 30% had combined approaches. Average anterior levels fused: 3.6, posterior: 4.8, and mean total number of levels fused: 4.5. Mean operative time for the cohort was 902.5 minutes with an average estimated blood loss of 830 ccs. The mean BL neck disability index (NDI) score was 56.5 and a mJOA of 12.81. While BL NDI score correlated with gender (P = 0.050), it did not correlate with BL global or cervical radiographic factors. An increased NDI score at 1Y postoperatively correlated with BL body mass index (P = 0.026). A decreased NDI score was associated with 1Y T12-S1 angle (P = 0.009) and 1Y T10 L2 angle (P = 0.013). Overall, BL mJOA score correlated with the BL radiographic factors of T1 slope (P = 0.005), cervical lordosis (P = 0.001), C2-T3 (P = 0.008), C2 sacral slope (P = 0.050), SVA (P = 0.010), and CL Apex (P = 0.043), as well as gender (P = 0.050). Linear regression modeling for the prior independent variables found a significance of P = 0.046 and an R2 of 0.367. Year 1 mJOA scores correlated with 1Y values for maximum kyphosis (P = 0.043) and TS-CL (P = 0.010). At 1Y, a smaller mJOA score correlated with BL S1 sacral slope (P = 0.014), pelvic incidence (P = 0.009), L1-S1 (P = 0.012), T12-S1 (P = 0.008). The linear regression model for those 4 variables demonstrated an R2 of 0.169 and a P = 0.005. An increased mJOA score correlated with PI-LL difference at 1Y (P = 0.012), L1-S1 difference (P = 0.036), T12-S1 difference (0.006), maximum lordosis (P = 0.026), T9-PA difference (P = 0.010), and difference of T4-PA (P = 0.008). Conclusions: While the impact of preoperative sagittal and cervical parameters on mJOA was strong, the BL radiographic factors did not impact NDI scores. PostOp HRQL was significantly associated with sagittal parameters for mJOA (both worsening and improvement) and NDI scores (improvement). When cervical surgery has been indicated, radiographic alignment is important for postoperative HRQL.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=62;epage=66;aulast=Passiascervical deformityhealth-related quality of lifepatient report outcomesradiographic parameters |
| spellingShingle | Peter Gust Passias Katherine E Pierce Bailey Imbo Lara Passfall Oscar Krol Rachel Joujon-Roche Tyler Williamson Kevin Moattari Peter Tretiakov Ammar Adenwalla Irene Chern Haddy Alas Cole A Bortz Avery E Brown Shaleen Vira Bassel G Diebo Daniel M Sciubba Renaud Lafage Virginie Lafage Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery Journal of Craniovertebral Junction and Spine cervical deformity health-related quality of life patient report outcomes radiographic parameters |
| title | Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| title_full | Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| title_fullStr | Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| title_full_unstemmed | Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| title_short | Cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| title_sort | cervical and spinopelvic parameters can predict patient reported outcomes following cervical deformity surgery |
| topic | cervical deformity health-related quality of life patient report outcomes radiographic parameters |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=62;epage=66;aulast=Passias |
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