215. Assessing key functional outcomes after multilevel fusion for adult spinal deformity in patients over 60 years of age: A prospective, observational, multicenter study with two-year follow-up

BACKGROUND CONTEXT Functional disability is a common presentation of adult spinal deformity (ASD). While several studies indicate that operative treatment can provide significant improvement in disability at 2-year follow-up, little information outlines and quantifies which key functions are most affected and improved from surgery. PURPOSE To evaluated the short- and long-term changes in self-reported functional outcomes in patients, over age of 60 years, with primary ASD treated with multilevel spinal fusion. STUDY DESIGN/SETTING Prospective multicenter cohort study. PATIENT SAMPLE This study included 219 patients 60 years or older, from 12 international sites, diagnosed with adult spinal deformity who required at least a 5-level spinal fusion procedure. Surgical procedure was per standard of care at the investigational sites. OUTCOME MEASURES Scoliosis Research Society 22r (SRS22r) function domain, and personal care, walking, sitting and standing sections from the Oswestry Disability Index (ODI). METHODS Follow-up visits were performed at 10 weeks (± 6 weeks), 12 months (± 2 months) and 24 months (± 2 months). Function was assessed using the Scoliosis Research Society 22r (SRS22r) function domain, and with the personal care, walking, sitting and standing sections from the Oswestry Disability Index (ODI). RESULTS A total of 219 patients (mean age 67.5 years old, 80.4% female) out of 255 enrolled met the inclusion criteria. Of those, 179 (82%) patients completed the 2-year study period. SRS22r function domain mean (SD) score was 2.7 (0.7) at baseline and at 10 weeks, and improved (P 10 minutes improved from 51% to 86%, sitting half an hour or more improved from 74% to 95%, and social life was not restricted in 36% of patients preoperatively compared to 74% at 2 years. Based on the SRS22r question 9, the percentage of patients functioning at 75% or more of their normal work activity improved from 17% preop to 51% at 2 years. CONCLUSIONS This study demonstrates and quantifies improvements in specific functions based on patient reported outcome scores in patients greater than 60 years of age undergoing multilevel spinal fusions for ASD. Specifically, significant improvements in standing, walking and social life were recorded at 2-year follow-up. At 24 months, 63% of patients can expect to walk a mile or more, 69% could stand and 95% could sit half an hour or more, and 51% of patients felt they functioned at 75% or better of their normal work. This study provides important practical numbers in terms of expected functional outcome in older patients undergoing multilevel spinal deformity surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.