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Impact of adult spinal deformity corrective surgery in patients with the symptoms of gastroesophageal reflux disease: a 5-year follow-up report

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Abstract

Purpose

Gastroesophageal reflux disease (GERD) is reported as one of the symptoms of adult spinal deformity (ASD). Little is known about the mid- to long-term improvement in GERD symptoms after ASD surgery. Therefore, this retrospective study from prospectively collected database aimed to investigate GERD symptoms in patients for a minimum of 2 years after ASD corrective surgery.

Methods

Records from 230 patients (mean age: 64 years) who underwent ASD surgery were examined using the frequency scale for the symptoms of GERD (FSSG) questionnaires for the diagnosis of GERD. FSSG scores and radiographic parameters were investigated preoperatively and postoperatively at 6 months and 1, 2, and 5 years.

Results

In total, 90 (39%) patients were preoperatively diagnosed with GERD defined by FSSG score ≥ 8 points. Radiographic results showed that the corrective surgeries improved local and global alignments. In the GERD patients, preoperative FSSG scores (16.1 ± 7.3 points) significantly improved to 7.7 ± 7.4 points within 6 months postoperatively (p < 0.001), and postoperative FSSG scores maintained at 1 year (9.9 ± 8.2 points, p = 0.061), 2 years (9.7 ± 8.2 points, p = 0.086), and 5 years (9.4 ± 8.0 points, p = 0.177). Among the GERD group, 62 patients (69%; improvement cases) showed improvement in GERD symptoms defined by FSSG score < 8 points within 6 months postoperatively.

Conclusions

Among ASD patients, 39% were diagnosed with GERD. In 69% of these patients, GERD symptoms improved within 6 months of corrective surgery and maintained up to 5 years postoperatively.

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Acknowledgments

We appreciate the help of Yuki Mihara, Sho Kobayashi, and Daisuke Togawa for case collections or manuscript discussions. We would like to thank Editage (www.editage.jp) for English language editing. Dr. Matsuyama supervised the study. Dr. Hasegawa was responsible for the study’s conception and design. Dr. Hasegawa and Dr. Ushirozako acquired, analyzed, and interpreted data, drafted the article, and approved the final version on behalf of all authors. All authors have critically revised the article and reviewed the submitted version.

Funding

Dr. Oe and Yamato belong to a donation-funded laboratory called the “Division of Geriatric Musculoskeletal Health.” Donations to this laboratory have been received from Medtronic Sofamor Danek, Inc.; Japan Medical Dynamic Marketing, Inc.; and the Meitoku Medical Institution Jyuzen Memorial Hospital.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan

    Tomohiko Hasegawa, Hiroki Ushirozako, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe & Yukihiro Matsuyama

  2. Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

    Yu Yamato & Shin Oe

  3. Department of Orthopaedic Surgery, Kindai University Nara Hospital, Ikoma, Nara, Japan

    Daisuke Togawa

  4. Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan

    Sho Kobayashi

Authors
  1. Tomohiko Hasegawa
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  2. Hiroki Ushirozako
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  3. Yu Yamato
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  9. Hideyuki Arima
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  10. Shin Oe
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  11. Tomohiro Yamada
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  12. Koichiro Ide
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  13. Yuh Watanabe
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  14. Yukihiro Matsuyama
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Corresponding author

Correspondence to Tomohiko Hasegawa.

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The other authors declare no conflicts of interest.

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All study participants provided informed consent, and the study design was approved by the appropriate ethics review board of Hamamatsu University School of Medicine.

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Hasegawa, T., Ushirozako, H., Yamato, Y. et al. Impact of adult spinal deformity corrective surgery in patients with the symptoms of gastroesophageal reflux disease: a 5-year follow-up report. Eur Spine J 29, 860–869 (2020). https://doi.org/10.1007/s00586-020-06300-2

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