1. Likelihood of reaching minimal clinically important difference in adult spinal deformity: A comparison of operative and nonoperative treatment
- Author
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Liu, S., Schwab, F., Smith, J. S., Klineberg, E., Ames, C. P., Mundis, G., Hostin, R., Kebaish, K., Deviren, V., Gupta, M., Boachie-Adjei, O., Hart, R. A., Bess, S., and Virginie Lafage
- Subjects
Disability evaluation ,pain management ,quality of life ,surgical procedures-operative ,Cardiovascular System & Hematology ,Clinical Research ,Rehabilitation ,Behavioral and Social Science ,surgical procedures–operative ,spinal cord diseases - Abstract
BackgroundFew studies have examined threshold improvements in health-related quality of life (HRQOL) by measuring minimal clinically important differences (MCIDs) in treatment of adult spinal deformity. We hypothesized that patients undergoing operative treatment would be more likely to achieve MCID threshold improvement compared with those receiving nonoperative care, although a subset of nonoperative patients may still reach threshold.MethodsWe analyzed a multicenter, prospective, consecutive case series of 464 patients: 225 nonoperative and 239 operative. To be included in the study, patients had to have adult spinal deformity, be older than 18 years, and have both baseline and 1-year follow-up HRQOL measures (Oswestry Disability Index [ODI], Short Form-36 [SF-36] health survey, and Scoliosis Research Society-22 [SRS-22] questionnaire). We compared the percentages of patients achieving established MCID thresholds between operative and nonoperative groups using risk ratios (RR) with a 95% confidence interval (CI).ResultsCompared to nonoperative patients, surgical patients demonstrated significant mean improvement (P