Activities of daily living and patient satisfaction after long fusion for adult spinal deformity: a retrospective study

• Published in: European spine journal Vol. 28; no. 7; pp. 1670 - 1677
• Main Authors: Ishikawa, Yoshinori, Miyakoshi, Naohisa, Kobayashi, Takashi, Abe, Toshiki, Kijima, Hiroaki, Abe, Eiji, Shimada, Yoichi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2019; Springer Nature B.V
• Subjects: Activities of daily living; Arthrodesis; Laundry; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Patient satisfaction; Quality of life; Scoliosis; Surgery; Surgical Orthopedics; Adult spinal deformity; Thoracolumbosacroiliac arthrodesis; Activities of daily living; Spinal mobility; Quality of life
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-019-05893-7

Purpose Spinal instrumented arthrodesis improves health-related quality of life (HRQOL), although mobility is impaired. This study evaluates activities of daily livings after thoracolumbosacroiliac arthrodesis for adult spinal deformity and patient satisfaction. Methods Fifty patients who underwent surgery filled self-administered questionnaires (1-year preoperative and postoperative conditions), and 36 patients (3 men and 33 women; mean age 71.4 years) participated in the study. Twenty-five activities, including weeding, snow shoveling, toilet activities, and sleeping postures, were examined. Spinal alignment with Scoliosis Research Society (SRS)—Schwab classification, HRQOL with SRS-22, complications, and patient satisfaction were evaluated. Pre- and postoperative conditions were statistically compared. Results Spinal alignment improved postoperatively. Comparison data revealed that strenuous activities, such as weeding and farm work, significantly deteriorated postoperatively in 42.1–87.5% patients. Other basic activities, excluding Western toilet usage, sleeping supine, laundry and kitchen chores, and changing jacket/pants, also significantly deteriorated in 21–88% patients. Only activities such as sleeping supine, standing upright, vacuuming, doing laundry, and reaching for objects placed at heights became possible with significant difference postoperatively among activities that could not be performed preoperatively. Light activities were continued, but strenuous activities were restricted. Nevertheless, the patient satisfaction rate was 70%. Six patients exhibited complications; however, none were dissatisfied with surgery outcomes. Instrumentation or proximal junctional failures were associated with at least one strenuous work activity. Conclusions Thoracolumbosacroiliac arthrodesis does not always improve activities postoperatively. Therefore, surgical indication for patients who continue activities preoperatively should be carefully decided. Level of Evidence Level 3. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.