Introduction: ASD is a cause of poor health related quality of life (HRQOL), however, health policy providers often underestimate ASD-associated disability. Purpose: compare ASD Standard Form Version 2 (SF-36) scores to age-specific normative data and disease-specific norms.
Methods: Multi-center, prospective analysis of consecutive patients, no prior history of spine surgery, treated operatively (OP) or nonoperatively for ASD. ASD demographic and SF-36 physical component scores (PCS) and mental component scores (MCS) were compared to US normative values, age generational values and disease specific norms. ASD SF-36 data reported as norm-based score (NBS) with standard deviations (sd), compared to NBS means and reported based upon minimally important difference (MID) values for PCS and MCS (3 NBS points).
Results: 497 ASD (mean age=50.4) met inclusion criteria. Mean ASD PCS was 3 MID values (9 NBS points) below the mean general population norm (ASD=41 sd 11; US mean=50). ASD MCS (49 sd 11) was similar to US mean MCD (50). ASD age generational PCS declined more rapidly with age than US age generational norms. Minimum one MID decline in PCS between generations occurred at an earlier age for ASD than US norms. All ASD generational PCS values were minimum one MID lower than US generational values. ASD MCS values were not MID compared to US generational norms, except for 55-64 age group. Comparing ASD PCS to disease specific PCS norms, mean ASD PCS was 4 MID values below mean PCS for healthy population (55), and had similar MID impact as cancer (41), diabetes (41), heart disease (39), and rheumatoid arthritis (40).
Conclusions: ASD can be a debilitating disease that impacts physical function to a similar degree as diabetes and heart disease. The impact of ASD worsens with age and warrants similar research and health policy attention as other diseases such as cancer and diabetes.
Patient Care: This research improves patient care by demonstrating the significant health impact of adult spinal deformity and providing comparisons of this impact to other more commonly recognized disease states.
Learning Objectives: By the conclusion of this presentation, participants should: (1) appreciate that adult spinal deformity (ASD) can be a debilitating disease that impacts physical function to a similar degree as diabetes and heart disease, (2) appreciate that ASD worsens with age and warrants similar research and health policy attention as other diseases such as cancer and diabetes.