TY  - JOUR
PY  - 2024//
TI  - Does global spinal alignment affect the use of walking aids after multi-segment spinal fixation for patients with ASD? A multicenter retrospective study
JO  - European spine journal
A1  - Ouchida, Jun
A1  - Nakashima, Hiroaki
A1  - Ito, Sadayuki
A1  - Segi, Naoki
A1  - Yamauchi, Ippei
A1  - Oishi, Ryotaro
A1  - Miyairi, Yuichi
A1  - Morita, Yoshinori
A1  - Ode, Yukihito
A1  - Nagatani, Yasuhiro
A1  - Okada, Yuya
A1  - Tsushima, Mikito
A1  - Machino, Masaaki
A1  - Ota, Kyotaro
A1  - Tachi, Hiroto
A1  - Kagami, Yujiro
A1  - Shinjo, Ryuichi
A1  - Ohara, Tetsuya
A1  - Tsuji, Taichi
A1  - Kanemura, Tokumi
A1  - Imagama, Shiro
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - PURPOSE: This study aimed to clarify the relation between global spinal alignment and the necessity of walking aid use in patients with adult spinal deformity (ASD) and to investigate the impact of spinal fixation on mobility status after surgery. <br><br>METHODS: In total, 456 older patients with ASD who had multi-segment spinal fixation surgery and were registered in a multi-center database were investigated. Patients under 60 years of age and those unable to walk preoperatively were excluded. Patients were classified by their mobility status into the independent, cane, and walker groups. Comparison analysis was conducted using radiographic spinopelvic parameters and the previously reported global spine balance (GSB) classification. In addition, preoperative and 2 years postoperative mobility statuses were investigated. <br><br>RESULTS: Of 261 patients analyzed, 66 used walking aids (canes, 46; walkers, 20). Analysis of preoperative radiographical parameters showed increased pelvic incidence and pelvic incidence-lumbar lordosis mismatch in the walker group and increased sagittal vertebral axis in the cane and walker groups versus the independent group. Analysis of GSB classification showed a higher percentage of walker use in those with severe imbalance (grade 3) in the sagittal classification but not in the coronal classification. While postoperative radiographical improvements were noted, there was no significant difference in the use of walking aids before and 2 years after surgery (P = 0.085). <br><br>CONCLUSION: A significant correlation was found between "sagittal" spinal imbalance and increased reliance on walking aids, particularly walkers. However, the limitation of improvement in postoperative mobility status suggested that multiple factors influence the mobility ability of elderly patients with ASD.<p />  <p>Language: en</p>
LA  - en
SN  - 0940-6719
UR  - http://dx.doi.org/10.1007/s00586-024-08380-w
ID  - ref1
ER  -