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Patient-Reported Outcomes After Adult Spinal Deformity Surgery: Are There Differences Between Primary and Revision

Amalie Schramm¹, Martin Heegaard¹, Lærke C Ragborg¹

¹Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DNK.

|June 9, 2025

Summary

Patients undergoing revision surgery for adult spinal deformity (ASD) report similar satisfaction and quality of life as those receiving primary surgery. This suggests comparable outcomes despite potential increases in morbidity for revision procedures.

Keywords:

adult spinal deformity asd revision surgery health-related quality of life patient satisfaction spine deformity surgery

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Area of Science:

Spine surgery outcomes
Adult spinal deformity (ASD)
Patient-reported outcomes

Background:

Surgical treatment for adult spinal deformity (ASD) improves quality of life but has a high revision rate.
Uncertainty exists regarding patient satisfaction after revision surgery compared to primary surgery.

Purpose of the Study:

To compare patient satisfaction and health-related quality of life (HRQoL) between revision and primary ASD surgery.

Main Methods:

Retrospective study of 185 adult patients undergoing primary or revision ASD surgery (≥5 levels) with ≥2 years of follow-up.
Assessment of HRQoL and treatment satisfaction using SRS-22r and EQ-5D-3L questionnaires.
Comparison of outcomes between primary surgery (n=97) and revision surgery (n=88) groups.

Main Results:

No significant difference in median satisfaction scores (p=0.096) between revision (4.0) and primary (4.0) surgery groups.
Similar SRS-22r subscores (p=0.087) and EQ-5D-3L index scores (p=0.106) were observed between the groups.
Revision surgery patients were older (mean age 59.8 vs 50.7 years, p<0.001).

Conclusions:

Patient-reported HRQoL and treatment satisfaction are comparable between revision and primary ASD surgery.
Patients can expect similar satisfaction after revision surgery as primary surgery, provided complications are absent.
Revision surgery may involve higher morbidity, but satisfaction levels remain consistent.