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Beitragstitel What do patients consider to be an acceptable level of symptoms to live with after surgery for adult spinal deformity?
Beitragscode P023
Autoren
  1. Anne F. Mannion Schulthess Clinic, Zurich, Switzerland Vortragender
  2. Sarah Wunderlin Schulthess Klinik Zürich
  3. Ibrahim Obeid Pellegrin Bordeaux University Hospital
  4. Ferran Pellise Hospital Vall d’Hebron
  5. Juan Bago
  6. Ahmet Alanay Acibadem Mehmet Ali Aydınlar University School of Medicine, Department of Orthopedics and Traumatology
  7. Francisco Perez Grueso
  8. Frank Stefan Kleinstück Schulthess Klinik Zürich
Präsentationsform Poster
Themengebiete
  • A03 - Wirbelsäule
Abstract Introduction: A new approach to the interpretation of treatment success comprises the reporting of the percentage of patients whose symptoms have reduced to an acceptable level, i.e., who have reached a satisfactory symptom state. We sought to evaluate the acceptable level of symptoms in patients after operative and non-operative treatment for adult spinal deformity (ASD), as measured by different outcome instruments.

Methods: This was a cross-sectional analysis of 12-mo outcome data from the database of an international observational study of patients with ASD (European Spine Study Group; ESSG). The following questionnaires were completed at 12 months’ follow-up: Oswestry Disability Index; Pain NRS; SRS-22 (from which the total score and the sub-domain scores for pain, function, self-image, and mental health were calculated for the brief 16-item set); and symptom-specific well-being (SSWB) “if you had to spend the rest of your life with the symptoms you have now, how would you feel about it?” (5-point response scale from “very satisfied” to “very dissatisfied”, dichotomised for use as external criterion in receiver operating characteristics (ROC) analysis to determine cut-off scores). Being at least “somewhat satisfied” with the current state was considered an acceptable state.

Results The data from 556 patients was available for analysis. 45% reported being in an "acceptable symptom state". The SRS scores corresponding to this state ranged from > 3.0 to > 3.8 depending on the specific SRS domain; for ODI the value was ≤ 22 and for pain ≤ 3. The ROC areas under the curve (AUC) were all relatively high (AUC 0.70-0.85), suggesting the questionnaire scores discriminated well between patients in an acceptable state or not.

Conclusion Many spine interventions can improve the patient’s complaints but rarely do they totally eliminate them. Reporting the percentage of patients achieving a score equivalent to the “acceptable state” may represent a more stringent target for denoting surgical success in the treatment of degenerative spinal disorders.