Neurologic Deficits Have a Negative Impact on Patient-Related Outcomes in Primary Presentation Adult Symptomatic Lumbar Scoliosis Surgical Treatment at One-Year Follow-up.
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ABSTRACT: A retrospective analysis of prospective, multicenter National Institute of Health clinical trial.The aim of this study was to assess the rate of neurologic complications and impact of new neurologic deficits on 1-year postoperative patient-reported outcomes (PROs).There are limited studies evaluating the impact of new neurologic deficits on PROs following surgery for primary presentation adult lumbar scoliosis.Patients were divided into two groups: new postoperative neurological deficit (Def) or no deficit (NoDef). Preoperative and 1-year follow-up PROs were analyzed [Scoliosis Research Society (SRS) Questionnaire, Oswestry Disability Index (ODI), Short Form-12 Physical/Mental Health Composite Scores (PCS/MCS), and back/leg pain Numerical Rating Scale (NRS)].One hundred forty-one patients: 14 Def (9.9%), 127 NoDef (90.1%). No differences were observed in demographic, radiographic, or PRO data between groups preoperatively. Def group had longer surgical procedures (8.3 vs. 6.9?hours, P?=?0.030), greater blood loss (2832 vs. 2606?mL, P?=?0.022), and longer hospitalizations (10.6 vs. 7.8 days, P?=?0.004). NoDef group reported significant improvement in all PROs from preop to 1-year postoperative. Def group only had improvement in SRS Pain (2.7 preop to 3.4 postop, P?=?0.037) and self-image domains (2.7 to 3.6, p?=?0.004), and NRS back pain (6.6 to 3.2, P?=?0.004) scores with significant worsening of NRS leg pain (4.1 to 6.1, P?=?0.045). Group comparisons of 1-year postop PROs found that Def group reported more NRS leg pain (6.1 vs. 1.7, P?
SUBMITTER: Kang DG
PROVIDER: S-EPMC5373095 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
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