Correlation analysis of spinopelvic parameters and quality of life in the adult deformity patients over 60 years old

English Keywords:Adult deformity  Sagittal  Quality of life  SRS-22

English Abstract:

  【Abstract】 Objectives: To investigate the correlations of spinopelvic parameters and quality of life in the adult deformity patients over 60 years old. Methods: From March 2014 to May 2016, 43 adult deformity patients (scoliosis with a Cobb angle of >20°, sagittal vertical axis of >5cm, or pelvic tilt >25°) over 60 years old were included, consisting of 12 adult degenerative scoliosis patients, 7 adult degenerative kyphosis patients, 12 adult degenerative kyphoscoliosis patients, 6 adult idiopathic scoliosis patients, 1 adult idiopathic kyphoscoliosi patient, and 5 post-traumatic kyphosis patients. There were 7 males and 36 females, with an average age of 64.0±3.5 years(range, 60.0-73.0 years). Scoliosis Research Society(SRS)-22, Oswestry disability index(ODI) questionnaires and visual analog scale(VAS) for back and leg pain were used to evaluate the quality of life of the adult deformity patients over 60 years old. Spinopelvic parameters were measured on standing lateral full-spine radiographs, including sagittal vertical axis(SVA), thoracic kyphosis(TK), lumbar lordosis(LL), pelvic incidence(PI), pelvic tilt(PT), sacral slope(SS) and T1 pelvic angle(TPA). In addition, the values of PI-LL were calculated. Pearson correlation was used to evaluate the relationships of sagittal parameters and quality of life in the adult deformity patients over 60 years old. Results: The scores of function, pain, self-image, mental health, and sub-total in the SRS-22 questionnaire were 13.4±2.1, 17.3±2.7, 13.2±3.0, 15.7±11.8 and 59.6±5.6 respectively. The average scores of ODI, VAS back and VAS leg were (46.8±17.8)%, 5.7±2.6 and 3.9±3.0 respectively. The mean values of SVA, TK, LL, PI, PT, SS, TPA and PI-LL were 6.5±6.2cm, 12.7°±15.8°, -16.9°±17.2°, 49.0°±12.3°, 30.2°±11.6°, 18.8°±10.6°, 28.8°±14.4° and 32.1°±17.8° respectively. Pearson correlation analysis showed SVA and TPA correlated with the score of function, pain, self-image, sub-score of SRS-22, ODI, VAS back pain(r=-0.386, -0.375, -0.361, -0.410, 0.445, 0.389, P<0.05; r=-0.403, -0.426, -0.466, -0.425, 0.512, 0.465 respectively, P<0.05). LL, PT and PI-LL were correlated with ODI and VAS back pain(r=0.368, 0.367, P<0.05; r=0.376, 0.341, P<0.05; r=0.401, 0.395, P<0.05 respectively). However, TK, PI, and SS showed no correlated with health related quality of life（P>0.05）. Conclusions: In the adult deformity patients over 60 years old, increased SVA and TPA can affect the function, self-image and back pain. Decreased LL, increased PT and increased PI-LL can aggravate the back pain of patients. TPA can both represent the sagittal alignment of spine and pelvis, which is correlated most strongly with the quality of life in patients.