Radiographic Axial Malalignment is Associated With Pretreatment Patient-Reported Health-Related Quality of Life Measures in Adult Degenerative Scoliosis: Implementation of a Novel Radiographic Software Tool

Retrospective study of prospectively collected data. The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) u...

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Bibliographic Details
Published in:Spine deformity 2018-11, Vol.6 (6), p.745-752
Main Authors: Faraj, Sayf S.A., Boselie, Toon F.M., Vila-Casademunt, Alba, de Kleuver, Marinus, Holewijn, Roderick M., Obeid, Ibrahim, Acaroglu, Emre, Alanay, Ahmet, Kleinstück, Frank, Pérez-Grueso, Francisco S., Pellisé, Ferran
Format: Article
Language:English
Subjects:
Adult degenerative scoliosis
Aged
Apical vertebral axial rotation
Axial malalignment
Female
Health-related quality of life
Humans
Male
Medicine & Public Health
Orthopedics
Patient-reported
Quality of Life
Radiography
Retrospective Studies
Scoliosis - diagnostic imaging
Software
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Summary:Retrospective study of prospectively collected data. The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) using a novel radiographic software tool. Recent studies have demonstrated that in ADS, sagittal and coronal plane deformity are weakly to moderately associated with HRQOL, disability, and pain. However, as ADS is a three-dimensional spinal deformity, the impact of axial malalignment on HRQOL is yet to be determined. A total of 74 ADS patients were enrolled. HRQOL measures included the Short Form-36v2 (SF-36v2) and Scoliosis Research Society questionnaire (SRS-22r). Disability and pain measures included the Oswestry Disability Index (ODI) and numeric rating scale back and leg pain. Radiographic measures included Cobb angle (CA), sagittal spinopelvic parameters, lateral and anteroposterior (AP) translation of the apical vertebra. The amount of apical vertebral axial rotation was measured on digital AP radiograph images using a novel software technology. Subjects were stratified into four clinical groups based on the degree of apical vertebral axial rotation. Apical vertebral axial rotation showed no association with lateral (r = 0.21; p = .15) and AP (r = 0.08, p = .80) translation of the apical vertebra. A significant moderate association was found between apical vertebral axial rotation and Cobb angle (r = 0.57; p < .05). Patients in the group with the highest degree of apical vertebral axial rotation reported significantly worse ODI and SRS-22r Subtotal and Pain scores (p < .05), irrespective of sagittal spinopelvic parameters. This is the first study that reports on the association between apical vertebral axial rotation and pretreatment HRQOL, disability, and pain in ADS. This study suggests that increased apical vertebral axial rotation is associated with suboptimal pretreatment health status scores. Level III.
ISSN:2212-134X
2212-1358
DOI:10.1016/j.jspd.2018.03.011