Changes in Physical Function After Long Corrective Fusion to the Ilium for Female Patients With Adult Spinal Deformity.

Abstract

Prospective cohort study. To investigate longitudinal changes in physical functional status after long corrective fusion in patients with adult spinal deformity (ASD) during 2 years of follow-up. In ASD surgery, reports assessing physical functional status in long-term observations for more than a year are lacking. Assessing whether patients maintain significant improvements in their physical status with a longer follow-up duration is crucial. A total of 70 female patients with ASD who underwent long corrective fusion of ≥7 segments between June 2016 and June 2022 were included in this study. Preoperative and postoperative assessments (at 6 mo, 1 yr, and 2 yr) included radiographic spinopelvic parameters, health-related quality of life using the Scoliosis Research Society Outcome Instrument-22 questionnaire, and physical function tests conducted by a physical therapist. All domains of the Scoliosis Research Society Outcome Instrument-22 improved the most in the first 6 months after surgery (P <0.0001); however, the "pain" and "function" domains continued to improve gradually until 2 years postoperatively. Regarding trunk dynamic balance, the timed up-and-go test score improved gradually until 2 years postoperatively (P < 0.0001). Regarding gait performance, gait speed, and the 6-minute walking test improved the most in the first 6 months after surgery (P < 0.01) and almost reached a plateau 1 year postoperatively. Long corrective fusion for ASD significantly enhanced physical function and health-related quality of life within 2 years, with the greatest improvement in the first 6 months after surgery. These findings underscore the importance of increasing activities of daily living through early exercise instruction, as well as preventive measures to avoid early surgery-related complications. Level III.