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Erschienen in: European Spine Journal 7/2019

07.03.2019 | Original Article

Adult spinal deformity surgical decision-making score

Part 1: development and validation of a scoring system to guide the selection of treatment modalities for patients below 40 years with adult spinal deformity

verfasst von: Takashi Fujishiro, Louis Boissière, Derek Thomas Cawley, Daniel Larrieu, Olivier Gille, Jean-Marc Vital, Ferran Pellisé, Francisco Javier Sanchez Pérez-Grueso, Frank Kleinstück, Emre Acaroglu, Ahmet Alanay, Ibrahim Obeid, European Spine Study Group, ESSG

Erschienen in: European Spine Journal | Ausgabe 7/2019

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Abstract

Purpose

We aimed to develop and internally validate a simple scoring system: the adult spinal deformity (ASD) surgical decision-making (ASD-SDM) score, which is specific to the decision-making process for ASD patients aged below 40 years.

Methods

A multicentre prospective ASD database was retrospectively reviewed. The scoring system was developed using data from a derivation cohort and was internally validated in a validation cohort. The accuracy of the ASD-SDM score was assessed using the area under the receiver operating characteristic curve (AUC).

Results

A total of 316 patients were randomly divided into derivation (253 patients, 80%) and validation (63 patients, 20%) cohorts. A 10-point scoring system was created from four variables: self-image score in the Scoliosis Research Society-22 score, coronal Cobb angle, pelvic incidence minus lumbar lordosis mismatch, and relative spinopelvic alignment, and the surgical indication was graded into low (score 0–4), moderate (score 5–7), and high (score 8–10) surgical indication groups. In the validation cohort, the AUC for selecting surgical management according to the ASD-SDM score was 0.789 (SE 0.057, P < 0.001, 95% CI 0.655–0.880). The percentage of patients treated surgically were 21.1%, 55.0%, and 80.0% in the low, moderate, and high surgical indication groups, respectively.

Conclusions

The ASD-SDM score, to the best of our knowledge, is the first algorithm to guide the decision-making process for the ASD population and could be one of the indices for aiding the selection of treatment for ASD.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.
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Metadaten
Titel
Adult spinal deformity surgical decision-making score
Part 1: development and validation of a scoring system to guide the selection of treatment modalities for patients below 40 years with adult spinal deformity
verfasst von
Takashi Fujishiro
Louis Boissière
Derek Thomas Cawley
Daniel Larrieu
Olivier Gille
Jean-Marc Vital
Ferran Pellisé
Francisco Javier Sanchez Pérez-Grueso
Frank Kleinstück
Emre Acaroglu
Ahmet Alanay
Ibrahim Obeid
European Spine Study Group, ESSG
Publikationsdatum
07.03.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 7/2019
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-019-05932-3

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