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Dose-response relationship between spino-pelvic alignment determined by sagittal modifiers and back pain-specific quality of life.
- Source :
-
European Spine Journal . Oct2021, Vol. 30 Issue 10, p3019-3027. 9p. 1 Diagram, 5 Charts, 5 Graphs. - Publication Year :
- 2021
-
Abstract
- Purpose: To determine whether abnormalities of the sagittal modifiers (SMs) of the Scoliosis Research Society (SRS)-Schwab classification truly reflect back pain (BP)-specific quality of life (QOL), it is necessary to examine their dose–response relationships and to determine clinically impactful thresholds for declines in BP-specific QOL. This study aimed to analyse the continuous dose–response relationship between each SM and BP-specific QOL. Methods: This cross-sectional study, using data from a Japanese population-based cohort study, included 519 community-dwelling residents aged ≥ 50 years who participated in the annual health examination. The participants completed the Roland–Morris Disability Questionnaire (RDQ) on BP-specific QOL. Spino-pelvic alignment based on SMs was assessed by whole-spine X-ray examinations. We fitted general linear models with or without nonlinear terms to estimate the dose–response relationship between each SM and BP-specific QOL. Results: Pelvic tilt, pelvic incidence minus lumbar lordosis (PI-LL), and sagittal vertical axis showed dose–response relationships with BP-specific QOL measured as the RDQ score. PI-LL was most likely to predict a minimally clinically important RDQ score when its value exceeded the 90th percentile. A nonlinear relationship between PI-LL and the BP-specific QOL score was found. RDQ increased when PI-LL exceeded 10°. Conclusion: PI-LL might be the most sensitive of the three modifiers of the SRS-Schwab classification for determining BP-specific QOL. Moreover, BP-specific QOL worsens rapidly when the compensatory mechanism against malalignment exceeds a critical value. Therefore, we suggest that traditional classifications and surgical strategies should be re-examined regarding the dose-dependent abnormalities of the SMs to develop a more reliable classification strategy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *QUALITY of life
*PERIODIC health examinations
*BACKACHE
Subjects
Details
- Language :
- English
- ISSN :
- 09406719
- Volume :
- 30
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- European Spine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 152605492
- Full Text :
- https://doi.org/10.1007/s00586-021-06965-3