Journal of Clinical Medicine (Apr 2024)
Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery
- Bassel G. Diebo,
- Daniel Alsoof,
- Renaud Lafage,
- Mohammad Daher,
- Mariah Balmaceno-Criss,
- Peter G. Passias,
- Christopher P. Ames,
- Christopher I. Shaffrey,
- Douglas C. Burton,
- Vedat Deviren,
- Breton G. Line,
- Alex Soroceanu,
- David Kojo Hamilton,
- Eric O. Klineberg,
- Gregory M. Mundis,
- Han Jo Kim,
- Jeffrey L. Gum,
- Justin S. Smith,
- Juan S. Uribe,
- Khaled M. Kebaish,
- Munish C. Gupta,
- Pierce D. Nunley,
- Robert K. Eastlack,
- Richard Hostin,
- Themistocles S. Protopsaltis,
- Lawrence G. Lenke,
- Robert A. Hart,
- Frank J. Schwab,
- Shay Bess,
- Virginie Lafage,
- Alan H. Daniels
Affiliations
- Bassel G. Diebo
- Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA
- Daniel Alsoof
- Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA
- Renaud Lafage
- Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA
- Mohammad Daher
- Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA
- Mariah Balmaceno-Criss
- Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA
- Peter G. Passias
- Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY 10016, USA
- Christopher P. Ames
- Department of Neurosurgery, University of California, San Francisco, CA 94115, USA
- Christopher I. Shaffrey
- Department of Neurosurgery, Duke Spine Division, Durham, NC 27708, USA
- Douglas C. Burton
- Department of Orthopaedic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA
- Vedat Deviren
- Department of Neurosurgery, University of California, San Francisco, CA 94115, USA
- Breton G. Line
- Denver International Spine Center, Denver, CO 80218, USA
- Alex Soroceanu
- Department of Orthopedic Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada
- David Kojo Hamilton
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Eric O. Klineberg
- Department of Orthopaedic Surgery, University of California, 1 Shields Ave., Davis, CA 95616, USA
- Gregory M. Mundis
- San Diego Spine, La Jolla, CA 92037, USA
- Han Jo Kim
- Hospital for Special Surgery, New York, NY 10021, USA
- Jeffrey L. Gum
- Leatherman Spine Center, Louisville, KY 40202, USA
- Justin S. Smith
- Department of Neurosurgery, University of Virginia, Charlottesville, VA 22903, USA
- Juan S. Uribe
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
- Khaled M. Kebaish
- Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA
- Munish C. Gupta
- Department of Orthopedics, Washington University in St Louis, St. Louis, MO 63110, USA
- Pierce D. Nunley
- Spine Institute of Louisiana, Shreveport, LA 71101, USA
- Robert K. Eastlack
- San Diego Spine, La Jolla, CA 92037, USA
- Richard Hostin
- Department of Orthopaedic Surgery, Baylor Scoliosis Center, 4708 Alliance Blvd #800, Plano, TX 75093, USA
- Themistocles S. Protopsaltis
- Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY 10016, USA
- Lawrence G. Lenke
- Department of Orthopedic Surgery, Columbia University Medical Center, The Spine Hospital at New York Presbyterian, New York, NY 10032, USA
- Robert A. Hart
- Swedish Neuroscience Institute, Seattle, WA 98027, USA
- Frank J. Schwab
- Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA
- Shay Bess
- Denver International Spine Center, Denver, CO 80218, USA
- Virginie Lafage
- Department of Orthopedic Surgery, Lenox Hill Northwell, New York, NY 10075, USA
- Alan H. Daniels
- Department of Orthopedics, Warren Alpert Medical School of Brown University, East Providence, RI 02914, USA
- DOI
- https://doi.org/10.3390/jcm13082202
- Journal volume & issue
-
Vol. 13,
no. 8
p. 2202
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 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.
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