The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort.
Jamie S. Terran,Frank J. Schwab,Christopher I. Shaffrey,Justin S. Smith,Pierre Devos,Christopher P. Ames,Kai-Ming G. Fu,Douglas Burton,Richard A. Hostin,Eric O. Klineberg,Munish C. Gupta,Vedat Deviren,Gregory M. Mundis,Robert A. Hart,Shay Bess,Virginie Lafage +15 more
TLDR
This study demonstrates that the SRS-Schwab classification reflects severity of disease state based on multiple measures of HRQOL and significantly correlates with the important decision of whether to pursue operative or nonoperative treatment.Abstract:
BACKGROUND The SRS-Schwab classification of adult spinal deformity (ASD) is a validated system that provides a common language for the complex pathology of ASD. Classification reliability has been reported; however, correlation with treatment has not been assessed. OBJECTIVE To assess the clinical relevance of the SRS-Schwab classification based on correlations with health-related quality of life (HRQOL) measures and the decision to pursue operative vs nonoperative treatment. METHODS Prospective analysis of consecutive ASD patients (18 years of age and older) collected through a multicenter group. The SRS-Schwab classification includes a curve type descriptor and 3 sagittal spinopelvic modifiers (sagittal vertical axis, pelvic tilt, pelvic incidence/lumbar lordosis mismatch). Differences in demographics, HRQOL (Oswestry Disability Index, SRS-22, Short Form-36), and classification between operative and nonoperative patients were evaluated. RESULTS A total of 527 patients (mean age, 52.9 years; range, 18.4-85.1 years) met inclusion criteria. Significant differences in HRQOL were identified based on SRS-Schwab curve type, with thoracolumbar and primary sagittal deformities associated with greater disability and poorer health status than thoracic or double curve deformities. Operative patients had significantly poorer grades for each of the sagittal spinopelvic modifiers, and progressively higher grades were associated with significantly poorer HRQOL (P < .05). Patients with worse sagittal spinopelvic modifier grades were significantly more likely to require major osteotomies, iliac fixation, and decompression (P ≤ .009). CONCLUSION The SRS-Schwab classification provides a validated language to describe and categorize ASD. This study demonstrates that the SRS-Schwab classification reflects severity of disease state based on multiple measures of HRQOL and significantly correlates with the important decision of whether to pursue operative or nonoperative treatment.read more
Citations
More filters
Journal ArticleDOI
2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth.
Stefano Negrini,Sabrina Donzelli,Angelo Gabriele Aulisa,Dariusz Czaprowski,Sanja Schreiber,Sanja Schreiber,Jean Claude de Mauroy,Helmut Diers,Theodoros B Grivas,Patrick Knott,Tomasz Kotwicki,Andrea Lebel,Cindy Marti,Toru Maruyama,Joseph P O'Brien,Nigel Price,Eric C. Parent,Manuel Rigo,Michele Romano,Luke Stikeleather,James H Wynne,Fabio Zaina +21 more
TL;DR: The 2016 SOSORT guidelines were developed based on the current evidence on CTIS and include a total of 68 recommendations divided into following topics: bracing, PSSE to prevent scoliosis progression during growth, other conservative treatments, respiratory function and exercises and assessment.
Journal ArticleDOI
TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life
Themistocles S. Protopsaltis,Frank J. Schwab,Nicolas Bronsard,Justin S. Smith,Eric O. Klineberg,Gregory M. Mundis,Devon J. Ryan,Richard A. Hostin,Robert A. Hart,Douglas Burton,Christopher P. Ames,Christopher I. Shaffrey,Shay Bess,Thomas J. Errico,Virginie Lafage +14 more
TL;DR: The T1 pelvic angle, a novel measure of sagittal alignment that simultaneously accounts for both spinal inclination and pelvic retroversion, correlates with health-related quality of life in patients with adult spinal deformity and can be useful as a preoperative planning tool.
Journal ArticleDOI
Impact on health related quality of life of adult spinal deformity (ASD) compared with other chronic conditions.
Ferran Pellisé,Alba Vila-Casademunt,Montse Ferrer,Montse Domingo-Sabat,Juan Bagó,Francisco Javier Sánchez Pérez-Grueso,Ahmet Alanay,Anne F. Mannion,Emre Acaroglu +8 more
TL;DR: The global burden of ASD was huge compared with other self-reported chronic conditions in the general population of eight industrialized countries and warrants the same research and health policy attention as other important chronic diseases.
Journal ArticleDOI
Reliability assessment of a novel cervical spine deformity classification system
Christopher P. Ames,Justin S. Smith,Robert K. Eastlack,Donald J. Blaskiewicz,Christopher I. Shaffrey,Frank J. Schwab,Shay Bess,Han Jo Kim,Gregory M. Mundis,Eric O. Klineberg,Munish C. Gupta,Michael J. O'Brien,Richard A. Hostin,Justin K. Scheer,Themistocles S. Protopsaltis,Kai-Ming G. Fu,Robert A. Hart,Todd J. Albert,K. Daniel Riew,Michael G. Fehlings,Vedat Deviren,Virginie Lafage +21 more
TL;DR: The proposed classification provides a mechanism to assess CSD within the framework of global spinopelvic malalignment and clinically relevant parameters and suggest moderate agreement and serve as the basis for subsequent improvement and study of the proposed classification.
Journal ArticleDOI
Prospective multicenter assessment of risk factors for rod fracture following surgery for adult spinal deformity
Justin S. Smith,Ellen Shaffrey,Eric O. Klineberg,Christopher I. Shaffrey,Virginie Lafage,Frank J. Schwab,Themistocles S. Protopsaltis,Justin K. Scheer,Gregory M. Mundis,Kai-Ming G. Fu,Munish C. Gupta,Richard A. Hostin,Vedat Deviren,Khaled M. Kebaish,Robert A. Hart,Douglas C. Burton,Breton Line,Shay Bess,Christopher P. Ames +18 more
TL;DR: There was a substantial range in the rate of RF with PSO across centers, suggesting potential variations in technique that warrant future investigation, and alternative instrumentation strategies should be considered for these cases.
References
More filters
Journal ArticleDOI
A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation☆
TL;DR: The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
Journal ArticleDOI
The Impact of Positive Sagittal Balance in Adult Spinal Deformity
Steven D. Glassman,Keith H. Bridwell,John R. Dimar,William C. Horton,Sigurd Berven,Frank J. Schwab +5 more
TL;DR: This study shows that although even mildly positive sagittal balance is somewhat detrimental, severity of symptoms increases in a linear fashion with progressive sagittal imbalance, and shows that kyphosis is more favorable in the upper thoracic region but very poorly tolerated in the lumbar spine.
Journal ArticleDOI
Correlation of radiographic parameters and clinical symptoms in adult scoliosis
TL;DR: This study suggests that restoration of a more normal sagittal balance is the critical goal for any reconstructive spine surgery and suggests that magnitude of coronal deformity and extent of Coronal correction are less critical parameters.
Journal ArticleDOI
Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity.
TL;DR: This study confirms that pelvic position measured via PT correlates withHRQOL in the setting of adult deformity and demonstrates significant T1–SPI correlation with HRQOL measures and outperforms SVA.
Journal ArticleDOI
Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study.
Frank J. Schwab,Benjamin Ungar,Benjamin Blondel,Jacob M. Buchowski,Jeffrey A. Coe,Donald Deinlein,Christopher J. DeWald,Hossein Mehdian,Christopher I. Shaffrey,Clifford B. Tribus,Virginie Lafage +10 more
TL;DR: Data from this study show that there is excellent inter- and intra- rater reliability and inter-rater agreement for curve type and each modifier and the high degree of reliability demonstrates that applying the classification system is easy and consistent.