Introduction: Understanding the economic impact of surgical treatment for ASD necessitates an understanding of the outcomes associated with the surgery. This study analyzes the impact of demographic variables and pathology of ASD on changes in HRQOL among patients receiving surgical treatment for four categories of ASD: Primary Idiopathic Scoliosis (PIS), Primary Degenerative Scoliosis (PDS), Primary Sagittal Plane Deformity (PSPD), and Revision (R).
Methods: Multi-center, retrospective analysis of 323 consecutive ASD patients (ages 18 to 85, with an average age of 54). Patients were assigned to one of four diagnostic categories based on pre-operative radiographs and history: PDS (n=59, 18%), PIS (n=102, 32%), PSPD (n=39, 12%), and R (n=123, 38%). HRQOL measures were based on the Medical Outcomes Study Short Form 36 (SF-36) physical and mental component scores (PCS and MCS, respectively), the Oswestry Disability Index (ODI), and the Scoliosis Research Society (SRS) questionnaires after at least one year following surgery.
Results: Patients reported significant improvement in all outcome measures except for SRS mental health: SF-36 MCS (mean=2.80; p<0.01), SF-36 PCS (5.98; p<0.01), ODI (9.27; p<0.01), SRS functional activity (0.41; p<0.01), SRS self-image (1.08; p<0.01), and SRS pain (0.88; p<0.01). No significant differences in HRQOL improvements were observed across different categories of ASD. Results indicate a significant (p<0.05) positive relationship between changes in HRQOL and age. Similarly, analysis of a subset of patients with BMI data (n=139) showed a significant (p<0.05) positive relationship between changes in HRQOL and BMI.
Conclusions: Improvements in HRQOL do not appear to be dependent on the diagnostic category of deformity. Although results differ somewhat across HRQOL measures, the analysis indicates that older patients and patients with higher BMI may exhibit significantly more improvement relative to younger patients and those with lower BMI.
Patient Care: The research will improve practice by identifying the impact of demographic and radiographic variables on a patient’s self-reported quality of life outcomes, allowing the development of a benefit profile for patients undergoing surgical treatment of spinal deformity.
Learning Objectives: By the conclusion of this session, participants should understand the effect of observed independent variables, including age, BMI, and diagnostic category of deformity, on a patient’s improvement in health related quality of life measures following surgical treatment for spinal deformity.