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Activities of daily living and patient satisfaction after long fusion for adult spinal deformity: a retrospective study

  • Yoshinori IshikawaEmail author
  • Naohisa Miyakoshi
  • Takashi Kobayashi
  • Toshiki Abe
  • Hiroaki Kijima
  • Eiji Abe
  • Yoichi Shimada
Original Article

Abstract

Purpose

Spinal instrumented arthrodesis improves health-related quality of life (HRQOL), although mobility is impaired. This study evaluates activities of daily livings after thoracolumbosacroiliac arthrodesis for adult spinal deformity and patient satisfaction.

Methods

Fifty patients who underwent surgery filled self-administered questionnaires (1-year preoperative and postoperative conditions), and 36 patients (3 men and 33 women; mean age 71.4 years) participated in the study. Twenty-five activities, including weeding, snow shoveling, toilet activities, and sleeping postures, were examined. Spinal alignment with Scoliosis Research Society (SRS)—Schwab classification, HRQOL with SRS-22, complications, and patient satisfaction were evaluated. Pre- and postoperative conditions were statistically compared.

Results

Spinal alignment improved postoperatively. Comparison data revealed that strenuous activities, such as weeding and farm work, significantly deteriorated postoperatively in 42.1–87.5% patients. Other basic activities, excluding Western toilet usage, sleeping supine, laundry and kitchen chores, and changing jacket/pants, also significantly deteriorated in 21–88% patients. Only activities such as sleeping supine, standing upright, vacuuming, doing laundry, and reaching for objects placed at heights became possible with significant difference postoperatively among activities that could not be performed preoperatively. Light activities were continued, but strenuous activities were restricted. Nevertheless, the patient satisfaction rate was 70%. Six patients exhibited complications; however, none were dissatisfied with surgery outcomes. Instrumentation or proximal junctional failures were associated with at least one strenuous work activity.

Conclusions

Thoracolumbosacroiliac arthrodesis does not always improve activities postoperatively. Therefore, surgical indication for patients who continue activities preoperatively should be carefully decided.

Level of Evidence

Level 3.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Adult spinal deformity Thoracolumbosacroiliac arthrodesis Spinal mobility Quality of life Activities of daily living 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

586_2019_5893_MOESM1_ESM.pptx (857 kb)
Supplementary material 1 (PPTX 856 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryAkita University Graduate School of MedicineAkitaJapan
  2. 2.Department of Orthopedic SurgeryAkita Kousei Medical CenterAkitaJapan

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