The Impact of Surgical Correction of Adult Spine Deformity on Radiological Parameters and Its Correlation With Clinical Outcomes

Abstract

To evaluate the correlations between changes in radiological parameters and clinical outcomes following adult spinal deformity (ASD) surgery. Radiological assessments are necessary for evaluation of deformity magnitude and choosing the appropriate surgical approach. Some studies have demonstrated the correlation between radiological parameters and pain and disability among patients. However, few studies have evaluated changes in both coronal and sagittal radiological parameters following the surgical treatment of ASD and its correlation with clinical outcomes. Radiological parameters include: pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and PI minus LL (PI-LL), and Cobb’s angle and three clinical outcome measures include: visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 health survey (SF-36), were assessed at baseline and 6 and 12 months after surgery. A total of 95 patients were included. Mean VAS scores and ODI significantly improved from 7.09±2.1 and 61.07±13.6 to 2.64±1.6 and 31.8±16.1 respectively, after surgery (both P<0.001). All items of the SF-36 survey, as well as all radiologic measures, improved significantly following surgery (both P<0.001). We found a significant negative correlation between pre-operative SS and VAS scores (r= -0.307, P=0.002). Energy (r= -0.262, P=0.010) and social functioning (r= -0.248, P=0.015) scales of SF-36. PI-LL was positively associated with ODI (r=0.223, P=0.030) before surgery and energy scale (r= -0.262, P=0.010) of SF-36 after surgery. Surgical treatment of patients with ASD improves clinical outcomes, and in line with previous studies, restoration of sagittal alignment has a more important role in the enhancement of patients’ function and quality of life.