title: Patient Satisfaction After Adult Spinal Deformity Surgery Does Not Strongly Correlate With Health-Related Quality of Life Scores, Radiographic Parameters, or Occurrence of Complications.
abstract: METHODS
  This is a multicenter retrospective review of prospectively collected cases.
  
  
  OBJECTIVE
  Our objective was to evaluate the relationship between patient satisfaction, health-related quality of life (HRQoL) scores, complications, and radiographic measures at 2 years postoperative follow-up.
  
  
  BACKGROUND
  For patients receiving operative management for adult spine deformity (ASD), the relationship between HRQoL measures, radiographic parameters, postoperative complications, and self-reported satisfaction remains unclear.
  
  
  METHODS
  Data from 248 patients across 11 centers within the United States who underwent thoracolumbar fusion for ASD and had a minimum of 2 years follow-up was collected. Pre- and postoperative scores were obtained from the Scoliosis Research Society 22-item (SRS-22r), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and the Visual Analogue Scale. Sagittal vertical axis, coronal C7 plumbline, lumbar lordosis, pelvic tilt, T1 pelvic angle, and the difference between pelvic incidence and lumbar lordosis were assessed using postoperative radiographic films. Satisfaction (SAT) was assessed using the SRS-22r; patients were categorized as highly satisfied (HS) or less satisfied (LS). The correlation between SAT and HRQoL scores, radiographic parameters, and complications was determined.
  
  
  RESULTS
  When compared with LS (n = 60) patients, HS (n = 188) patients demonstrated greater improvement in final ODI, SF-36 component scores, SRS-Total, and Visual Analogue Scale back scores (P < 0.05). The correlations between SAT and the final follow-up and 2 year change from baseline values were moderate for Mental Component Summary, Physical Component Summary, and ODI or weak for HRQoL scores (P < 0.0001). The HS and LS groups were equal in pre- or final postoperative radiographic parameters. Occurrence of complications had no effect on satisfaction.
  
  
  CONCLUSIONS
  Among operatively treated ASD patients, satisfaction was moderately correlated with some HRQoL measures, and not with radiographic changes or postoperative complications. Other factors, such as patient expectations and relationship with the surgeon, may be stronger drivers of patient satisfaction.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: David Kojo
authors.initials: DK
authors.lastname: Hamilton
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kong
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Jayme
authors.initials: J
authors.lastname: Hiratzka
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Alec G
authors.initials: AG
authors.lastname: Contag
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Tamir
authors.initials: T
authors.lastname: Ailon
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Breton
authors.initials: B
authors.lastname: Line
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Alan
authors.initials: A
authors.lastname: Daniels
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Peter
authors.initials: P
authors.lastname: Passias
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Themistocles
authors.initials: T
authors.lastname: Protopsaltis
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sciubba
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Douglas
authors.initials: D
authors.lastname: Burton
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Christopher
authors.initials: C
authors.lastname: Shaffrey
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Eric
authors.initials: E
authors.lastname: Klineberg
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Gregory
authors.initials: G
authors.lastname: Mundis
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Han-Jo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Renaud
authors.initials: R
authors.lastname: Lafage
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Justin
authors.initials: J
authors.lastname: Scheer
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
authors.forename: Oheneba
authors.initials: O
authors.lastname: Boachie-Adjei
authors.forename: Shay
authors.initials: S
authors.lastname: Bess
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hart
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D057566:Self Report; D013122:Spinal Diseases / Q000601:surgery*