2023 Volume 14 Issue 11 Pages 1383-1389
Purpose: The aim of this study was to assess the relationships of residual low back pain with radiographic, patient characteristics, and patient-reported outcomes (PROs) following adult spinal deformity (ASD) surgery.
Materials and methods: A total of 63 patients with ASD who underwent long fusion (>5 levels) from the thoracic spine to the pelvis were included. The following clinical outcome measures were used: Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), Oswestry Disability Index (ODI), and visual analog scale (VAS) for low back pain (LBP). Radiographic parameters included thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), and sagittal vertical axis (SVA). Residual low back pain was defined as the VAS for LBP ≥50 mm at final follow-up. Patient characteristics, radiographic parameters, and PROs were compared between the two groups. Multiple logistic regression analysis was used to identify risk factors associated with residual low back pain.
Results: Overall, the VAS for LBP was significantly improved from 71.4 mm to 36.6 mm postoperatively (P<0.001). The ODI was significantly improved from 52.5% to 35.2% postoperatively (P<0.001). The JOABPEQ were significantly improved except for mental health. Residual low back pain (VAS>50 mm) was found in 33%. There were no significant differences in patient characteristics, surgical characteristics, and radiographic parameters between the two groups. The preoperative VAS for LBP, ODI, and JOABPEQ were significantly worse in the residual LBP group than in the non-LBP group. No significant risk factor was found for residual low back pain.
Conclusion: The VAS for LBP was significantly improved postoperatively, but residual low back pain was found in 33% of cases.