Study design: Prospective radiographic and clinical analysis.
Objective: To evaluate whether radiographic spinopelvic parameters correlate with health-related quality of life (HRQOL) measures, in the long run, in patients operated on scoliosis in adult age.
Summary of background data: There are papers that correlate sagittal radiographic parameters with HRQOL scores for healthy spine as well as for some spinal disorders. However, there are limited studies evaluating correlations between HRQOL measures, radiographic spinopelvic parameters, and age in patients operated on scoliosis in adult age.
Methods: Fifty-nine patients, older than 21 years at surgery time (median: 50.2 years), were operated upon at a single center. All of them suffered mainly frontal deformity, idiopathic or degenerative curves, and long fusions, with more than a 2-year follow-up (median:8.5 years). Full-length freestanding radiographs, including the spine and pelvis, and SRS22 and SF36 instruments, were available for every patient at final follow-up. Sagittal and frontal radiographic parameters and age were analyzed for correlation with HRQOL. A multivariate analysis was performed.
Results: No significant correlation was found between frontal parameters and HRQOL measures. Spearman rank order test showed correlation (P < 0.001) between Scoliosis Research Society (SRS) activity and sagittal vertical axis (SVA) (r = -0.44), pelvic tilt (PT) (r = -0.49), and age (r = -0.5). SRS total was correlated (P < 0.004) with PT (r = -0.32) and age (r = -0.41). SF36 physical function correlated (P < 0.001) with SVA (r = -0.44), PT (r = -0.45), and age (r = -0.56). After multivariate analysis, only age and PT persisted as possible predictors of worse SRS activity scores.
Conclusion: After primary surgery for adult scoliosis, frontal radiographic parameters did not correlate with HRQOL measures. In univariate analysis, patient age, SVA, and PT correlated with activity scores, although the correlation coefficients did not reach high values. After multivariate analysis, SVA was not a predictor of function.