SRS22R Appearance Domain Correlates Most With Patient Satisfaction After Adult Deformity Surgery to the Sacrum at 5-year Follow-up.
METHODS
Longitudinal cohort.


OBJECTIVE
To evaluate the relationship between Scoliosis Research Society-22R (SRS22-R) domains and satisfaction with management in patients who underwent surgical correction for adult spine deformity.


BACKGROUND
The SRS-22R is used to measure clinical outcomes in adult spine deformity patients. The relationship between patient satisfaction and SRS-22R domain scores, the Oswestry Disability Index (ODI) and radiographical parameters has not been reported at 5-year follow-up.


METHODS
135 patients with adult spinal deformity at a single institution who underwent a posterior spinal fusion of 5 levels or more to the sacrum and had complete SRS-22R pre- and minimum 5-year postoperative were identified. Wilcoxon tests were used to compare preoperative and 5-year postoperative scores. Spearman correlations were used to evaluate associations between the 5-year SRS-22R Satisfaction score and changes in SRS-22R domain scores, SubScore (SRS-22R Total-Satisfaction), ODI, and radiographical parameters.


RESULTS
There were 125 females and 10 males with a mean BMI of 26.6 kg/m and mean age of 53.6 years. There were 74 primary and 61 revision surgeries with a mean 9.9 levels fused and mean follow-up of 67 months. There was a statistically significant improvement between paired pre- and 5-year postop SRS-22R domain scores and most radiographical parameters, commonly P ≤ 0.001. The majority of patients had an SRS-22R Satisfaction score of 3.0 or more (88%) or 4.0 or more (67%), consistent with a moderate ceiling effect. Correlations for SRS-22R domain scores were all statistically significant and either weak [Mental (0.26), Activity (0.27), Pain (0.35), or moderate (Appearance (0.59))]. SRS-22R SubScore (0.54) and ODI (0.43) also had a moderate correlation. Correlations for all radiographical and operative parameters were either very weak or weak.


CONCLUSIONS
SRS-22R Appearance, SubScore, and ODI correlate most with patient satisfaction in adult deformity patients undergoing 5 or more level fusion to the sacrum at 5-year follow-up.


METHODS
2.
*Norton Leatherman Spine Center, Louisville, KY †Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO ‡Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL; and §Department of Surgery, Division of Neurosurgery, Duke University Medical Center, Durham, NC.
Jeffrey L
JL
Gum
Keith H
KH
Bridwell
Lawrence G
LG
Lenke
David B
DB
Bumpass
Patrick A
PA
Sugrue
Isaac O
IO
Karikari
Leah Y
LY
Carreon
D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D057234:Preoperative Period; D011859:Radiography; D012086:Reoperation; D012447:Sacrum; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D013123:Spinal Fusion; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae