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. 2023 Sep 20;105(18):1410-1419.
doi: 10.2106/JBJS.23.00031. Epub 2023 Jul 21.

Height Gain Following Correction of Adult Spinal Deformity

Bassel G Diebo  1 , Zachary Tataryn  2 , Daniel Alsoof  1 , Renaud Lafage  3 , Robert A Hart  2 , Peter G Passias  4 , Christopher P Ames  5 , Justin K Scheer  5 , Stephen J Lewis  6 , Christopher I Shaffrey  7 , Douglas C Burton  8 , Vedat Deviren  5 , Breton G Line  9 , Alex Soroceanu  10 , D Kojo Hamilton  11 , Eric O Klineberg  12 , Gregory M Mundis  13 , Han Jo Kim  14 , Jeffrey L Gum  15 , Justin S Smith  16 , Juan S Uribe  17 , Michael P Kelly  18 , Khaled M Kebaish  19 , Munish C Gupta  20 , Pierce D Nunley  21 , Robert K Eastlack  13 , Richard Hostin  22 , Themistocles S Protopsaltis  4 , Lawrence G Lenke  23 , Frank J Schwab  3 , Shay Bess  9 , Virginie Lafage  3 , Alan H Daniels  1 ; the International Spine Study Group
Collaborators, Affiliations

Height Gain Following Correction of Adult Spinal Deformity

Bassel G Diebo et al. J Bone Joint Surg Am. .

Abstract

Background: Height gain following a surgical procedure for patients with adult spinal deformity (ASD) is incompletely understood, and it is unknown if height gain correlates with patient-reported outcome measures (PROMs).

Methods: This was a retrospective cohort study of patients undergoing ASD surgery. Patients with baseline, 6-week, and subanalysis of 1-year postoperative full-body radiographic and PROM data were examined. Correlation analysis examined relationships between vertical height differences and PROMs. Regression analysis was utilized to preoperatively estimate T1-S1 and S1-ankle height changes.

Results: This study included 198 patients (mean age, 57 years; 69% female); 147 patients (74%) gained height. Patients with height loss, compared with those who gained height, experienced greater increases in thoracolumbar kyphosis (2.81° compared with -7.37°; p < 0.001) and thoracic kyphosis (12.96° compared with 4.42°; p = 0.003). For patients with height gain, sagittal and coronal alignment improved from baseline to postoperatively: 25° to 21° for pelvic tilt (PT), 14° to 3° for pelvic incidence - lumbar lordosis (PI-LL), and 60 mm to 17 mm for sagittal vertical axis (SVA) (all p < 0.001). The full-body mean height gain was 7.6 cm, distributed as follows: sella turcica-C2, 2.9 mm; C2-T1, 2.8 mm; T1-S1 (trunk gain), 3.8 cm; and S1-ankle (lower-extremity gain), 3.3 cm (p < 0.001). T1-S1 height gain correlated with the thoracic Cobb angle correction and the maximum Cobb angle correction (p = 0.002). S1-ankle height gain correlated with the corrections in PT, PI-LL, and SVA (p < 0.001). T1-ankle height gain correlated with the corrections in PT (p < 0.001) and SVA (p = 0.03). Trunk height gain correlated with improved Scoliosis Research Society (SRS-22r) Appearance scores (r = 0.20; p = 0.02). Patient-Reported Outcomes Measurement Information System (PROMIS) Depression scores correlated with S1-ankle height gain (r = -0.19; p = 0.03) and C2-T1 height gain (r = -0.18; p = 0.04). A 1° correction in a thoracic scoliosis Cobb angle corresponded to a 0.2-mm height gain, and a 1° correction in a thoracolumbar scoliosis Cobb angle resulted in a 0.25-mm height gain. A 1° improvement in PI-LL resulted in a 0.2-mm height gain.

Conclusions: Most patients undergoing ASD surgery experienced height gain following deformity correction, with a mean full-body height gain of 7.6 cm. Height gain can be estimated preoperatively with predictive ratios, and height gain was correlated with improvements in reported SRS-22r appearance and PROMIS scores.

Level of evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/H620 ).

Comment in

References

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