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Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes. METHODS: This study was based on a prospective, multicenter observational ACSD cohort. Be...

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Autores principales: Smith, Justin S., Shaffrey, Christopher I., Kim, Han Jo, Passias, Peter, Protopsaltis, Themistocles, Lafage, Renaud, Mundis, Gregory M., Klineberg, Eric, Lafage, Virginie, Schwab, Frank J., Scheer, Justin K., Kelly, Michael, Hamilton, D. Kojo, Gupta, Munish, Deviren, Vedat, Hostin, Richard, Albert, Todd, Riew, K. Daniel, Hart, Robert, Burton, Doug, Bess, Shay, Ames, Christopher P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542159/
https://www.ncbi.nlm.nih.gov/pubmed/31192099
http://dx.doi.org/10.1177/2192568218794164
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author Smith, Justin S.
Shaffrey, Christopher I.
Kim, Han Jo
Passias, Peter
Protopsaltis, Themistocles
Lafage, Renaud
Mundis, Gregory M.
Klineberg, Eric
Lafage, Virginie
Schwab, Frank J.
Scheer, Justin K.
Kelly, Michael
Hamilton, D. Kojo
Gupta, Munish
Deviren, Vedat
Hostin, Richard
Albert, Todd
Riew, K. Daniel
Hart, Robert
Burton, Doug
Bess, Shay
Ames, Christopher P.
author_facet Smith, Justin S.
Shaffrey, Christopher I.
Kim, Han Jo
Passias, Peter
Protopsaltis, Themistocles
Lafage, Renaud
Mundis, Gregory M.
Klineberg, Eric
Lafage, Virginie
Schwab, Frank J.
Scheer, Justin K.
Kelly, Michael
Hamilton, D. Kojo
Gupta, Munish
Deviren, Vedat
Hostin, Richard
Albert, Todd
Riew, K. Daniel
Hart, Robert
Burton, Doug
Bess, Shay
Ames, Christopher P.
author_sort Smith, Justin S.
collection PubMed
description STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes. METHODS: This study was based on a prospective, multicenter observational ACSD cohort. Best versus worst outcomes were compared based on Neck Disability Index (NDI), Neck Pain Numeric Rating Scale (NP-NRS), and modified Japanese Orthopaedic Association (mJOA) scores. RESULTS: Of 111 patients, 80 (72%) had minimum 1-year follow-up. For NDI, compared with best outcome patients (n = 28), worst outcome patients (n = 32) were more likely to have had a major complication (P = .004) and to have undergone a posterior-only procedure (P = .039), had greater Charlson Comorbidity Index (P = .009), and had worse postoperative C7-S1 sagittal vertical axis (SVA; P = .027). For NP-NRS, compared with best outcome patients (n = 26), worst outcome patients (n = 18) were younger (P = .045), had worse baseline NP-NRS (P = .034), and were more likely to have had a minor complication (P = .030). For the mJOA, compared with best outcome patients (n = 16), worst outcome patients (n = 18) were more likely to have had a major complication (P = .007) and to have a better baseline mJOA (P = .030). Multivariate models for NDI included posterior-only surgery (P = .006), major complication (P = .002), and postoperative C7-S1 SVA (P = .012); models for NP-NRS included baseline NP-NRS (P = .009), age (P = .017), and posterior-only surgery (P = .038); and models for mJOA included major complication (P = .008). CONCLUSIONS: Factors distinguishing best and worst ACSD surgery outcomes included patient, surgical, and radiographic factors. These findings suggest areas that may warrant greater awareness to optimize patient counseling and outcomes.
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spelling pubmed-65421592019-06-12 Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery Smith, Justin S. Shaffrey, Christopher I. Kim, Han Jo Passias, Peter Protopsaltis, Themistocles Lafage, Renaud Mundis, Gregory M. Klineberg, Eric Lafage, Virginie Schwab, Frank J. Scheer, Justin K. Kelly, Michael Hamilton, D. Kojo Gupta, Munish Deviren, Vedat Hostin, Richard Albert, Todd Riew, K. Daniel Hart, Robert Burton, Doug Bess, Shay Ames, Christopher P. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes. METHODS: This study was based on a prospective, multicenter observational ACSD cohort. Best versus worst outcomes were compared based on Neck Disability Index (NDI), Neck Pain Numeric Rating Scale (NP-NRS), and modified Japanese Orthopaedic Association (mJOA) scores. RESULTS: Of 111 patients, 80 (72%) had minimum 1-year follow-up. For NDI, compared with best outcome patients (n = 28), worst outcome patients (n = 32) were more likely to have had a major complication (P = .004) and to have undergone a posterior-only procedure (P = .039), had greater Charlson Comorbidity Index (P = .009), and had worse postoperative C7-S1 sagittal vertical axis (SVA; P = .027). For NP-NRS, compared with best outcome patients (n = 26), worst outcome patients (n = 18) were younger (P = .045), had worse baseline NP-NRS (P = .034), and were more likely to have had a minor complication (P = .030). For the mJOA, compared with best outcome patients (n = 16), worst outcome patients (n = 18) were more likely to have had a major complication (P = .007) and to have a better baseline mJOA (P = .030). Multivariate models for NDI included posterior-only surgery (P = .006), major complication (P = .002), and postoperative C7-S1 SVA (P = .012); models for NP-NRS included baseline NP-NRS (P = .009), age (P = .017), and posterior-only surgery (P = .038); and models for mJOA included major complication (P = .008). CONCLUSIONS: Factors distinguishing best and worst ACSD surgery outcomes included patient, surgical, and radiographic factors. These findings suggest areas that may warrant greater awareness to optimize patient counseling and outcomes. SAGE Publications 2018-08-16 2019-05 /pmc/articles/PMC6542159/ /pubmed/31192099 http://dx.doi.org/10.1177/2192568218794164 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Smith, Justin S.
Shaffrey, Christopher I.
Kim, Han Jo
Passias, Peter
Protopsaltis, Themistocles
Lafage, Renaud
Mundis, Gregory M.
Klineberg, Eric
Lafage, Virginie
Schwab, Frank J.
Scheer, Justin K.
Kelly, Michael
Hamilton, D. Kojo
Gupta, Munish
Deviren, Vedat
Hostin, Richard
Albert, Todd
Riew, K. Daniel
Hart, Robert
Burton, Doug
Bess, Shay
Ames, Christopher P.
Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title_full Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title_fullStr Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title_full_unstemmed Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title_short Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
title_sort comparison of best versus worst clinical outcomes for adult cervical deformity surgery
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542159/
https://www.ncbi.nlm.nih.gov/pubmed/31192099
http://dx.doi.org/10.1177/2192568218794164
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