Spinopelvic changes based on the simplified SRS-Schwab adult spinal deformity classification: relationships with disability and health-related quality of life in adult patients with prolonged degenerative spinal disorders
Kyrölä, K., Repo, J., Mecklin, J.-P., Ylinen, J., Kautiainen, H., & Häkkinen, A. (2018). Spinopelvic changes based on the simplified SRS-Schwab adult spinal deformity classification: relationships with disability and health-related quality of life in adult patients with prolonged degenerative spinal disorders. Spine, 43(7), 497-502. https://doi.org/10.1097/BRS.0000000000002370
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2018Copyright
© 2017 Wolters Kluwer Health, Inc. This is a final draft version of an article whose final and definitive form has been published by Wolters Kluwer Health, Inc. Published in this repository with the kind permission of the publisher.
Study Design. Cross-sectional, observational study.
Objective. To study the occurrence of sagittal malalignment,
the adaptability of a simplified sagittal modifiers grading of the
Scoliosis Research Society (SRS)-Schwab adult spinal deformity
(ASD) classification, and the deformity-specific SRS questionnaire
version 30 (SRS-30) in an unselected adult cohort with
symptomatic degenerative spinal disorders.
Summary of Background Data. The sagittal modifiers of the
SRS-Schwab ASD classification correlate with health-related
quality of life (HRQoL) measures in patients with ASD. The
deformities and disabilities caused by sagittal malalignment in
patients with common degenerative spinal disorders of multiple
etiologies are rarely studied. A simplified and categorizing
version of the SRS-Schwab ASD classification in relation to the
Oswestry Disability Index (ODI) and the SRS-30 outcomes has
not yet been developed.
Methods. We recruited 874 consecutive patients with degenerative
spinal disorders between March 2013 and February 2014.
Full spine radiographs were taken and the patients divided into
sagittal deformity severity groups: mild or none, moderate, and
marked deformity. Participants completed the ODI, SRS-30, and
a general health questionnaire.
Results. We included 637 patients in the analysis. The severity
of sagittal deformity was mild or none in 407 (63.9%) patients,
moderate in 159 (25.0%), and marked in 71 (11.1%). Linearity
across the modifier grades and deformity classes was found for
ODI total score (P ¼ 0.033), and the function/activity (P ¼ 0.004)
and self-image/appearance (P¼ 0.030) domains of the SRS-30.
Age, body mass index, duration of symptoms, and the use of
painkillers increased while physical activity, working, and educational
status decreased significantly with deformity severity.
Conclusion. Sagittal spinopelvic malalignment is significantly
related to deterioration of the ODI and the SRS-30 in symptomatic
adults with degenerative spinal disorders. The SRS-Schwab
classification sagittal modifiers categorized into three groups is a
practical tool to detect various clinically significant grades of
deformity in a cohort with no recognized ASD.
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