title: Adult spinal deformity: a very heterogeneous population of patients with different needs.
abstract: OBJECTIVE
  The purpose of this study was to analyze and demonstrate the heterogeneity in adult spinal deformity (ASD) populations by baseline health-related quality of life (HRQL) data.
  
  
  METHODS
  ASD was defined as patients over 18 years of age with any of the following: coronal deformity >20°, sagittal vertical axis (SVA) >5 cm, pelvic tilt >25°, or thoracic kyphosis >60°. Three hundred fifty-two patients meeting the above definition of ASD were analyzed for measures of HRQL (Oswestry disability index [ODI], SRS-22 [Scoliosis Research Society-22], and SF-36 [Short form-36 health survey] questionnaires) at presentation. Age groups were defined as 18-40, 40-60, and >60 years. Deformity was analyzed as either degenerative (DS) or idiopathic (IS) (294 patients; 71 degenerative, 223 idiopathic).
  
  
  RESULTS
  There were significant differences between age groups--predominantly between the lower age group (18-40) and others--for all HRQL parameters except SRS-22 mental health and SF-36 mental component score. Similarly, HRQL measures for DS and IS deformities were significantly different. Regarding location of main curves, thoracolumbar/lumbar (TL/L) (70.2%) was dominant for the DS group and thoracic (55%) for the IS group. Mean age was 65 years for the DS group and 36 for the IS group, which were significantly different. Radiographic parameters were also significantly different between these groups, with IS patients having more coronal deformity and better sagittal balance.
  
  
  CONCLUSIONS
  ASD patients are very heterogeneous at presentation, depending on age and diagnosis. There is a distinct need to stratify ASD as early and late presentation ASD and/or by diagnosis. Patients with IS deformity may be very different from those with DS deformity, even at time of presentation. These differences must be taken into consideration in treatment of these patients, as well as for the analysis of the results of treatment.
authors: Ankara Spine Center, Department of Orthopedics, Ankara, Turkey.
authors: Rıfat Emre
authors: RE
authors: Acaroğlu
authors: Ankara Spine Center, Department of Orthopedics, Ankara, Turkey.
authors: Özgür
authors: Ö
authors: Dede
authors: Hospital Vall d'Hebron, Department of Orthopedics, Barcelona, Spain.
authors: Ferrán
authors: F
authors: Pellisé
authors: Ankara Spine Center, Department of Orthopedics, Ankara, Turkey.
authors: Ümit O
authors: ÜO
authors: Güler
authors: Hospital Vall d'Hebron, Department of Orthopedics, Barcelona, Spain.
authors: Montse
authors: M
authors: Domingo-Sàbat
authors: Acıbadem Maslak Hospital, Department of Orthopedics, İstanbul, Turkey.
authors: Ahmet
authors: A
authors: Alanay
authors: Hospital La Paz, Department of Orthopedics, Madrid, Spain.
authors: Francisco Sanchez
authors: FS
authors: Pérez-Grueso
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011788:Quality of Life; D011859:Radiography / Q000379:methods; D013121:Spinal Curvatures / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D014421:Turkey