Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery.
Publication Title
J Clin Med
Document Type
Article
Publication Date
4-11-2024
Keywords
washington; swedish; swedish neurosciences
Abstract
Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence-lumbar lordosis (PI-LL), and surgical invasiveness score. Results: In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (-1.2 vs. -3.6°, p = 0.039) for a comparable PI-LL correction (-11.9 vs. -15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years. Conclusions: Patients with a self-reported loss of balance/unsteady gait have significantly worse PROMs and higher risk of PJK.
Clinical Institute
Neurosciences (Brain & Spine)
Specialty
Neurosciences
Specialty
Surgery
Recommended Citation
Diebo, Bassel G; Alsoof, Daniel; Lafage, Renaud; Daher, Mohammad; Balmaceno-Criss, Mariah; Passias, Peter G; Ames, Christopher P; Shaffrey, Christopher I; Burton, Douglas C; Deviren, Vedat; Line, Breton G; Soroceanu, Alex; Hamilton, David Kojo; Klineberg, Eric O; Mundis, Gregory M; Kim, Han Jo; Gum, Jeffrey L; Smith, Justin S; Uribe, Juan S; Kebaish, Khaled M; Gupta, Munish C; Nunley, Pierce D; Eastlack, Robert K; Hostin, Richard; Protopsaltis, Themistocles S; Lenke, Lawrence G; Hart, Robert A; Schwab, Frank J; Bess, Shay; Lafage, Virginie; Daniels, Alan H; and ISSG, "Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery." (2024). Articles, Abstracts, and Reports. 8881.
https://digitalcommons.providence.org/publications/8881