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- Title
Adult spinal deformity surgical decision-making score. Part 2: development and validation of a scoring system to guide the selection of treatment modalities for patients above 40 years with adult spinal deformity.
- Authors
Fujishiro, Takashi; Boissière, Louis; Cawley, Derek Thomas; Larrieu, Daniel; Gille, Olivier; Vital, Jean-Marc; Pellisé, Ferran; Pérez-Grueso, Francisco Javier Sanchez; Kleinstück, Frank; Acaroglu, Emre; Alanay, Ahmet; Obeid, Ibrahim; European Spine Study Group, ESSG
- Abstract
<bold>Purpose: </bold>We aimed to develop and internally validate a scoring system, the adult spinal deformity surgical decision-making (ASD-SDM) score, to guide the decision-making process for ASD patients aged above 40 years.<bold>Methods: </bold>A multicentre prospective ASD database was retrospectively reviewed. The scoring system was developed using data from a derivation set and was internally validated in a validation set. The performance of the ASD-SDM score for predicting surgical management was assessed using the area under the receiver operating characteristic curve (AUC).<bold>Results: </bold>A total of 702 patients were included for analysis in the present study. The scoring system developed based on 562 patients, ranging from 0 to 12 points, included five parameters: leg pain scored by the numerical rating scale; pain and self-image domains in the Scoliosis Research Society-22 score; coronal Cobb angle; and relative spinopelvic alignment. Surgical indication was graded as low (score 0 to 4), moderate (score 5 to 7), and high (score 8 to 12) groups. In the validation set of 140 patients, the AUC for predicting surgical management according to the ASD-SDM score was 0.797 (standard error = 0.037, P < 0.001, 95% confidence interval = 0.714 to 0.861), and in the low, moderate, and high surgical indication groups, 23.7%, 43.5%, and 80.4% of the patients, respectively, were treated surgically.<bold>Conclusions: </bold>The ASD-SDM score demonstrated reliability, with higher scores indicating a higher probability of surgery. This index could aid in the selection of surgery for ASD patients in clinical settings. These slides can be retrieved under Electronic Supplementary Material.
- Subjects
PATIENT selection; RECEIVER operating characteristic curves; SPINAL surgery; CLINICAL prediction rules; SPINAL curvatures; RESEARCH evaluation; RETROSPECTIVE studies
- Publication
European Spine Journal, 2020, Vol 29, Issue 1, p45
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-019-06068-0