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Redefining Clinical Success Following Adult Spine Deformity Surgery Using a Multifactorial Composite Metric
Blerta Budani1, Paramveer Kaur1, Shay R Bess2
1Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY.
Spine
|June 9, 2026
Summary
Defining surgical success in adult spinal deformity (ASD) surgery requires a multidimensional approach. Composite success measures, considering disability, pain, and revisions, better reflect outcomes and patient satisfaction than single metrics.
Area of Science:
- Spine surgery outcomes research
- Orthopedic surgery
- Deformity correction analysis
Background:
- Adult spinal deformity (ASD) presents diverse challenges, with surgery aiming to improve function, reduce pain, and minimize revisions.
- Current evaluations of surgical success in ASD are often limited, lacking a comprehensive, multifactorial assessment.
Purpose of the Study:
- To establish a multidimensional definition of surgical success for adult spinal deformity (ASD) surgery.
- To evaluate the achievement rates of this composite success definition across various patient subgroups.
Main Methods:
- A retrospective multicenter registry study analyzed 1,084 patients with ASD.
- Surgical success was defined by improvements in disability (ODI), leg pain (NRS Leg), and avoidance of reoperation at 2-year follow-up.
- Patients were categorized by preoperative disability and pain levels; success rates were compared across these groups and deformity types.
Main Results:
- The overall composite success rate was 40.5%, with individual success rates for disability (60.9%), leg pain (64.8%), and revision avoidance (81.2%).
- Patients without preoperative high disability or pain achieved the highest composite success (59.4%).
- Composite success strongly correlated with patient satisfaction (87.2%) and willingness to undergo repeat treatment (94.4%).
Conclusions:
- A multidimensional definition of surgical success, incorporating disability, pain, and revision rates, provides a more comprehensive assessment for ASD surgery.
- Identifying patient characteristics associated with higher success rates aids in evidence-based patient selection and preoperative counseling.
- This framework supports outcome-driven surgical planning for adult spinal deformity.
