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The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities

BACKGROUND: Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investi...

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Autores principales: Perna, Andrea, Proietti, Luca, Smakaj, Amarildo, Velluto, Calogero, Meluzio, Maria Concetta, Rovere, Giuseppe, Florio, Daniela, Zirio, Gianfranco, Tamburrelli, Francesco Ciro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630841/
https://www.ncbi.nlm.nih.gov/pubmed/34847906
http://dx.doi.org/10.1186/s12891-021-04823-3
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author Perna, Andrea
Proietti, Luca
Smakaj, Amarildo
Velluto, Calogero
Meluzio, Maria Concetta
Rovere, Giuseppe
Florio, Daniela
Zirio, Gianfranco
Tamburrelli, Francesco Ciro
author_facet Perna, Andrea
Proietti, Luca
Smakaj, Amarildo
Velluto, Calogero
Meluzio, Maria Concetta
Rovere, Giuseppe
Florio, Daniela
Zirio, Gianfranco
Tamburrelli, Francesco Ciro
author_sort Perna, Andrea
collection PubMed
description BACKGROUND: Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL. METHODS: Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery. RESULTS: Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p <  0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA <  10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p <  0.0021). CONCLUSION: Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients.
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spelling pubmed-86308412021-12-01 The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities Perna, Andrea Proietti, Luca Smakaj, Amarildo Velluto, Calogero Meluzio, Maria Concetta Rovere, Giuseppe Florio, Daniela Zirio, Gianfranco Tamburrelli, Francesco Ciro BMC Musculoskelet Disord Research BACKGROUND: Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL. METHODS: Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery. RESULTS: Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p <  0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA <  10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p <  0.0021). CONCLUSION: Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients. BioMed Central 2021-11-30 /pmc/articles/PMC8630841/ /pubmed/34847906 http://dx.doi.org/10.1186/s12891-021-04823-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Perna, Andrea
Proietti, Luca
Smakaj, Amarildo
Velluto, Calogero
Meluzio, Maria Concetta
Rovere, Giuseppe
Florio, Daniela
Zirio, Gianfranco
Tamburrelli, Francesco Ciro
The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title_full The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title_fullStr The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title_full_unstemmed The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title_short The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
title_sort role of femoral obliquity angle and t1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630841/
https://www.ncbi.nlm.nih.gov/pubmed/34847906
http://dx.doi.org/10.1186/s12891-021-04823-3
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