Impact of New Motor Deficit on HRQOL After Adult Spinal Deformity Surgery: Subanalysis From Scoli Risk 1 Prospective...

Area of Science:

• Orthopedics
• Neurosurgery
• Quality of Life Research

Background:

• Adult spinal deformity surgery carries significant morbidity, including the risk of new postoperative motor deficits.
• The impact of these new motor deficits on patient-reported Health-related Quality of Life (HRQOL) scores remains unclear.

Purpose of the Study:

• To assess the effect of new motor deficits on HRQOL scores in patients undergoing adult deformity surgery.
• To investigate the relationship between the severity of motor deficits and HRQOL outcomes.

Main Methods:

• International, multicenter, prospective, longitudinal observational cohort study.
• Enrolled 272 adult spinal deformity patients with major curves (Cobb > 80°) undergoing three-column osteotomy.
• Collected American Spinal Injury Association (ASIA) scores and standard HRQOL scores pre-operatively and at 6 weeks, 6 months, and 2 years post-operatively.

Main Results:

• Patients with lower extremity motor scores (LEMS) worsening reported worse HRQOL scores compared to motor-neutral or improved groups.
• Patients with >2 points of LEMS worsening experienced the most significant negative HRQOL changes.
• Despite initial worsening, patients with motor deficits showed overall HRQOL improvement at 6 months and 2 years compared to baseline.

Conclusions:

• New motor deficits following adult spinal deformity surgery negatively impact overall HRQOL.
• The degree of motor deficit worsening correlates with the magnitude of HRQOL decline.
• Even with motor deficits, long-term HRQOL outcomes can improve post-surgery.