The Influence of Roussouly Classification Based Spinal Morphology and GAP Score on Postoperative Clinical Efficacy of Adult Spinal Deformities
Objective To evaluate the Roussouly sagittal spinal morphology before and after surgery for adult spinal deformity(ASD)and the impact of global alignment and promotion(GAP)score on postoperative clinical efficacy.Methods A retrospective analysis was conducted on the clinical data of 72 ASD patients who under-went surgical treatment in our hospital from January 2016 to December 2021,including 20 males and 52 fe-males,with an average age of(46.9±19.0)years old.Patients were classified according to their current[based on pelvic incidence angle(PI)]and theoretical[based on sacral inclination angle(SS)]Roussouly classification of spinal morphology.The patient's"theoretical"shape was determined based on PI(a constant parameter),and then the ideal shape parameters of this type were compared with the actual parameters.If the patient's"cur-rent"Roussouly spine shape 3 months after surgery matched all the parameters of their"theoretical"Roussouly spine shape,they were assigned to the matching group.Otherwise,they were assigned to the non matching group.The GAP scores before and after surgery for two groups of patients were calculated based on relevant pa-rameters,and the visual analogue scale(VAS),Oswestry disability index(ODI),and SRS-22 scores(including total score,pain,function,self-image,mental health,and treatment satisfaction)at preoperative,postoperative 3 months,and final follow-up were collected.Simultaneously,the occurrence of mechanical complications during patient follow-up was recorded.The differences between two groups in imaging parameters,GAP score,func-tional score,and mechanical complications were compared.Results Among the 72 ASD patients in this group,the preoperative spinal morphology was mainly Roussouly Ⅰ and Ⅱ,while postoperative morphology was mainly Roussouly Ⅱ and Ⅲ.All patients showed significant improvement in postoperative imaging parameters and clini-cal efficacy scores compared to preoperative levels(P all＜0.05).Inter group comparison showed that the non matching group had a higher pelvic tilt angle and overall trunk tilt angle at the last follow-up than the matching group(P all＜0.05).The GAP score of the matching group was lower than that of the group at 3 months and the last follow-up(P all＜0.05).The matching group had better VAS score,ODI score,and SRS-22 score(includ-ing total score,pain,function,and treatment satisfaction)than the non matching group at 3 months and the last follow-up,and the difference was statistically significant(P all＜0.05).The incidence of postoperative me-chanical complications was lower in the matching group(P＜0.05),and the optimal position of the lumbar lordosis vertex during surgery can reduce the incidence of mechanical complications.Conclusion After ASD surgery,patients who match the ideal Roussouly classification of the spinal sagittal plane have better clinical efficacy and GAP scores,lower incidence of mechanical complications,and should be corrected to the ideal Roussouly clas-sification of the spinal morphology as much as possible during the PI surgery.
万方数据
维普
