2021 Volume 12 Issue 9 Pages 1143-1151
Introduction: Although surgery for adult spinal deformity (ASD) reportedly has good clinical outcomes, it also has unsolved issues. In this study, we conducted a satisfaction survey of patients who had undergone corrective surgery for ASD.
Methods: Subjects included 55 patients who had undergone corrective surgery for ASD and were followed up for over 1 year. Background data, surgical data, radiographic parameter, SRS-22R, ODI, and an original questionnaire were obtained. The questionnaire included five-step evaluation of back pain, appearance, balance and appetite; five different ADL assessments for trunk stiffness; surgical expectations, achievement, and satisfaction. Patients were divided into two groups based on the degree of satisfaction. Univariate analysis followed by logistic regression analysis was performed to extract the satisfaction factor.
Results: Surgical satisfaction was found to be 82%. As the satisfaction factor, improvement in back pain was selected by 55% of patients. As the dissatisfaction factor, trunk stiffness was selected by 45% of patients. Approximately 95% of patients were satisfied when preoperative expectations were achieved, whereas only 55% of patients were satisfied when preoperative expectations were not achieved. Improvement in back pain (OR = 4.58, p = 0.001), amount of change in lumbar lordosis before and after surgery (10 degree increment, OR = 2.34, p = 0.022), and amount of change in pelvic tilt before and after surgery (10 degree increment, OR = 2.79, p = 0.048) were extracted as the contributing factors.
Conclusions: The factor that contributed the most to satisfaction was improvement in back pain. Surgically acquired LL and PT and long spinal fusion were believed to contribute to the improvement in back pain. Moreover, the achievement of preoperative expectations was shown to significantly improve satisfaction (p<0.001). It is important that the preoperative expectations regarding surgery are individually identified for post-operative satisfaction and that sufficient information is provided preoperatively regarding the achievement of these expectations.
