Article Figures & Data
Figures
- Figure 1
Basic demographics of a sample patient utilizing the European Spine Study Group-International Spine Study Group calculator.
- Figure 2
Radiographic alignment of a sample patient utilizing the European Spine Study Group-International Spine Study Group calculator.
- Figure 3
Health-related quality of life metrics of a sample patient utilizing the European Spine Study Group-International Spine Study Group calculator.
- Figure 4
Planned surgical characteristics of a sample patient utilizing theEuropean Spine Study Group-International Spine Study Group calculator.
- Figure 5
(A) Case example: baseline full standing coronal radiograph, (B) case example: baseline full standing lateral radiograph.
- Figure 6
(A) Case example: follow-up coronal radiograph, (B) case example: follow-up lateral radiograph.
Tables
Frailty Factors Body mass index <18.5 or >30 Heart disease Work status Depression Diabetes Hypertension Osteoporosis Blood clots Bladder incontinence Bowel incontinence Predicted Observed Brier Score Likelihood of improvement in ODI 89.2% 79.2% 0.0013 Likelihood of improvement in SRS-22 mental health 71.1% 66.7% 0.0019 Likelihood of improvement in SRS-22 subtotal 87.6% 83.3% 0.0018 Major complication at 2 y 53.4% 34.8% 0.034 Abbreviations: ODI, Oswestry Disability Index; SRS, Scoliosis Research Society.
- Table 3
Comparing the ESSG-ISSG calculator with other commonly used risk stratification tools.
Predictive Tool Factors Used to Predict Outcomes Measured Outcome ESSG-ISSG calculator Twelve basic patient demographics: gender, age, height, weight, smoking history, prior spine surgery, heel walk, toe walk, leg weakness, ASA grade, NRS back pain, NRS leg pain
Nine radiographic parameters: major curve location, Cobb angle, coronal balance, leg length discrepancy, L1-S1 angle, pelvic tilt, sacral slope, sagittal balance, global alignment
8 HRQL questions
Nine surgical characteristics: number of stages, use of bone graft, use of antifibrinolytics, number of levels fused, upper instrumented vertebra, lower instrumented vertebra, implant density, posterior rod material, posterior rod diameterMajor complications, reinterventions, readmissions, and patient-reported outcomes including SRS-22, Oswestry Disability Index, SF36v2 Charlson Comorbidity Index Age, history of MI, CHF, PVD, DM, CKD, CVA/TIA, AIDS, liver disease, connective tissue disease, peptic ulcer disease, hemiplegia, solid tumor, leukemia, lymphoma Estimated 10-y survival based on medical comorbidities ACS-NSQIP Calculator Age, BMI, functional status, ASA class
History of HTN, DM, CHF, COPD, acute kidney injury, CKD requiring dialysis, smoking, ascites, sepsis, disseminated cancerPostoperative risk of any complications, severe complications, cardiac complications, and death SpineSageT Age, BMI, gender, diagnosis
Level (cervical, thoracic, lumbar),
Approach (anterior, lateral, posterior)
Previous spine surgery, revision surgery, previous cardiac complications
History of CVA/TIA, COPD, asthma, HTN, rheumatoid arthritis, kidney disease, cancer, syncope/seizure, anemia, bleeding disorder, DM, CHFExpected complication rates after various types of spine surgery ASA Patients clinically classified into 1 of the following categories based on multiple factors:
I: normal healthy patient
II: mild systemic disease
III: severe systemic disease
IV: severe systemic disease constant threat to life
V: moribund patient not expected to survive without the operationPreoperative risk of undergoing anesthesia mFI-5 CHF within 30 d of surgery
Partially or totally dependent functional health status at time of surgery
History of DM, COPD or pneumonia, HTNOccurrence of adverse postoperative outcomes mFI-11 Functional status, history of HTN, DM, MI, PVD, CVD, cerebrovascular disease ± neurologic deficit, impaired sensorium, respiratory problems, other cardiac problems Occurrence of adverse postoperative outcomes Abbreviations: ASA, American Society of Anesthesiology; BMI, body mass index; CHF, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; CVD, cardiovascular disease; DM, diabetes mellitus; ESSG, European Spine Study Group; HTN, hypertension; ISSG, International Spine Study Group; mFI, modified frailty index; MI, myocardial infarction; NRS, numeric rating scale; PVD, peripheral vascular disease; TIA, transient ischemic attack.
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