Durability of Alignment in the Sagittal Age-Adjusted Score Following Surgical Adult Spinal Deformity Correction — The International Society for the Study of the Lumbar Spine
  1. Schedule
  2. GENERAL POSTER SESSION
  3. Durability of Alignment in the Sagittal Age-Adjusted Score Following Surgical Adult Spinal Deformity Correction

Durability of Alignment in the Sagittal Age-Adjusted Score Following Surgical Adult Spinal Deformity Correction (#1123)

Peter Passias 1 , Bailey Imbo 1 , Tyler Williamson 1 , Rachel Joujon-Roche 1 , Oscar Krol 1 , Peter Tretiakov 1 , Andrew Schoenfeld 2 , Paul Park 3 , Praveen Mummaneni 4 , Virginie Lafage 4 , Renaud Lafage 5 , Muhammad Burhan Janjua 6 , Dean Chou 4 , Shaleen Vira 7 , Bassel Diebo 8
  1. Department of Orthopaedic Surgery, NYU Langone, New York, NY, United States
  2. Department of Orthopedic Surgery, Brigham and Women's Center for Surgery and Public Health, Boston, MA, USA
  3. Department of Neurologic Surgery, University of Michigan, Ann Arbor, Michigan, USA
  4. Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
  5. Hospital for Special Surgery, New York
  6. Department of Orthopaedics, Lenox Hill Hospital, Northwell Health, New York, NY, USA
  7. UT Southwestern, Dallas
  8. SUNY Downstate, New York

Introduction: Despite multiple reports showing positive long-term alignment outcomes following adult spinal deformity (ASD) corrective surgery, it is still unclear to the effect of which this is true regarding the Sagittal age-adjusted score (SAAS).

Methods: Included: ASD surgical patients (≥18yrs, scoliosis≥20°, SVA≥5cm, PT≥25° and/or TK>60°) with available baseline (BL) radiographs, and 1-year postop (1Y) radiographs for patients matched in Sagittal age-adjusted score (SAAS, 1 < x > -1points) at 1Y. Patient cohorts were created: those remaining matched in SAAS beyond 1Y postop (sustained alignment), and those who did not (deteriorated alignment). Means comparison tests assessed differences in patient-related and surgical variables between cohorts. Significance was set p<0.05.

Results: Included were 220 surgical ASD patients (57.7yrs, 27.4kg/m2, 77% Female, CCI: 1.49), all of which were matched in SAAS at 1Y postop. 116 patients (52.7%) went from unmatched in SAAS at BL to matched at 1Y postop. Adjusted for patients lost to follow-up, patients matched in SAAS following their 1Y postoperative interval was: 71.0% at 2Y postop, 59.1% at 3Y, and 33.7% at both 2Y and 3Y. There were no differences in BL age, BMI, CCI, mFI or surgical variables (Levels fused, LIV, UIV, OpTime, EBL) between sustained alignment and deteriorated alignment cohorts. Patients who sustained alignment beyond 1Y had better outcomes as shown by the ODI (20.6 vs. 28.5; p=0.039), SF-36 Role physical (46.0 vs. 40.6; p=0.038), and SF-36 Body Pain (45.4 vs. 41.0; p=0.040) at 1Y follow-up.

Conclusions: SAAS is a novel ASD classification system with three age adjusted radiographic parameters. Once postop matched alignment is achieved, a substantial amount of patients remain matched at subsequent follow-ups and these patients are observed to have superior reported outcomes.

#ISSLS2022