Height Gain After Spinal Fusion for Idiopathic Scoliosis: Which Model Fits Best?
Journal
Journal of pediatric orthopedics
ISSN: 1539-2570
Titre abrégé: J Pediatr Orthop
Pays: United States
ID NLM: 8109053
Informations de publication
Date de publication:
01 Oct 2022
01 Oct 2022
Historique:
pubmed:
11
8
2022
medline:
15
9
2022
entrez:
10
8
2022
Statut:
ppublish
Résumé
Patients will often inquire about the magnitude of height gain after scoliosis surgery. Several published models have attempted to predict height gain using preoperative variables. Many of these models reported good internal validity but have not been validated against an external cohort. We attempted to test the validity of 5 published models against an external cohort from our institution. Models included were Hwang, Van Popta, Spencer, Watanabe, and Sarlak models. We retrospectively queried our institution's records from 2006 to 2019 for patients with adolescent idiopathic scoliosis treated with posterior spinal fusion. We recorded preoperative and postoperative variables including clinical height measurements. We also performed radiographic measurements on preoperative and postoperative radiographic studies. We then tested the ability of the models to predict height gain by evaluating Pearson correlation coefficient, root mean square error, Akaike Information Criterion for each model. A total of 387 patients were included. Mean clinical height gain was 3.1 (±1.7) cm.All models demonstrated a moderate positive Pearson correlation coefficient, except the Hwang model, which demonstrated a weak correlation. The Spencer model was the only model with acceptable root mean square error (≤0.5) and was also the best fitting with the lowest Akaike Information Criterion (-308). The mean differences in height gain predictions between all models except the Hwang model was ≤1 cm. Four of the 5 models demonstrated moderate correlation and had good external validity compared with their development cohorts. Although the Spencer model was the best fitting, the clinical significance of the difference in height predictions compared with other models was low. The Watanabe model was the second best fitting and had the simplest formula, making it the most convenient to use in a clinical setting. We offer a simplified equation to use in a preoperative clinical setting based on this data-ΔHeight (mm)=0.77*(preoperative coronal angle-postoperative coronal angle). Not Applicable.
Sections du résumé
BACKGROUND
BACKGROUND
Patients will often inquire about the magnitude of height gain after scoliosis surgery. Several published models have attempted to predict height gain using preoperative variables. Many of these models reported good internal validity but have not been validated against an external cohort. We attempted to test the validity of 5 published models against an external cohort from our institution. Models included were Hwang, Van Popta, Spencer, Watanabe, and Sarlak models.
METHODS
METHODS
We retrospectively queried our institution's records from 2006 to 2019 for patients with adolescent idiopathic scoliosis treated with posterior spinal fusion. We recorded preoperative and postoperative variables including clinical height measurements. We also performed radiographic measurements on preoperative and postoperative radiographic studies. We then tested the ability of the models to predict height gain by evaluating Pearson correlation coefficient, root mean square error, Akaike Information Criterion for each model.
RESULTS
RESULTS
A total of 387 patients were included. Mean clinical height gain was 3.1 (±1.7) cm.All models demonstrated a moderate positive Pearson correlation coefficient, except the Hwang model, which demonstrated a weak correlation. The Spencer model was the only model with acceptable root mean square error (≤0.5) and was also the best fitting with the lowest Akaike Information Criterion (-308). The mean differences in height gain predictions between all models except the Hwang model was ≤1 cm.
CONCLUSIONS
CONCLUSIONS
Four of the 5 models demonstrated moderate correlation and had good external validity compared with their development cohorts. Although the Spencer model was the best fitting, the clinical significance of the difference in height predictions compared with other models was low. The Watanabe model was the second best fitting and had the simplest formula, making it the most convenient to use in a clinical setting. We offer a simplified equation to use in a preoperative clinical setting based on this data-ΔHeight (mm)=0.77*(preoperative coronal angle-postoperative coronal angle).
LEVEL OF EVIDENCE
METHODS
Not Applicable.
Identifiants
pubmed: 35948528
doi: 10.1097/BPO.0000000000002225
pii: 01241398-202210000-00002
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-461Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Archer I, Dickson R. Stature and idiopathic scoliosis. A prospective study. J Bone Joint Surg Br. 1985;67-B:185–188.
Bjure J, Grimby G, Nachemson A. Correction of body height in predicting spirometric values in scoliotic patients. Scand J Clin Lab Invest. 1968;21:190–192.
Grivas TB, Arvaniti A, Maziotou C, et al. Comparison of body weight and height between normal and scoliotic children. Stud Health Technol Inform. 2002;91:47–53.
Ylikoski M. Height of girls with adolescent idiopathic scoliosis. Eur Spine J. 2003;12:288–291.
Bastrom TP, Bartley CE, Newton PO. Patient-Reported SRS-24 Outcomes Scores after surgery for adolescent idiopathic scoliosis have improved since the new millennium. Spine Deform. 2019;7:917–922.
Aghdasi B, Bachmann KR, Clark D, et al. Patient-reported outcomes following surgical intervention for adolescent idiopathic scoliosis. Clin Spine Surg A Spine Publ. 2020;33:24–34.
Rao RR, Hayes M, Lewis C, et al. Mapping the road to recovery: shorter stays and satisfied patients in posterior spinal fusion. J Pediatr Orthop. 2017;37:e536–e542.
Sudo H, Ito M, Kaneda K, et al. Long-term outcomes of anterior spinal fusion for treating thoracic adolescent idiopathic scoliosis curves. Spine (Phila Pa 1976). 2013;38:819–826.
Lonner BS, Ren Y, Yaszay B, et al. Evolution of surgery for adolescent idiopathic scoliosis over 20 years. Spine (Phila Pa 1976). 2018;43:402–410.
Watanabe K, Hosogane N, Kawakami N, et al. Increase in spinal longitudinal length by correction surgery for adolescent idiopathic scoliosis. Eur Spine J. 2012;21:1920–1925.
Hwang SW, Samdani AF, Lonner BS, et al. A multicenter analysis of factors associated with change in height after adolescent idiopathic scoliosis deformity surgery in 447 patients. J Neurosurg Spine. 2013;18:298–302.
Spencer HT, Gold ME, Karlin LI, et al. Gain in spinal height from surgical correction of idiopathic scoliosis. J Bone Jt Surg. 2014;96:59–65.
van Popta D, Stephenson J, Verma R. Change in spinal height following correction of adolescent idiopathic scoliosis. Spine J. 2016;16:199–203.
Langlais T, Verdun S, Compagnon R, et al. Prediction of clinical height gain from surgical posterior correction of idiopathic scoliosis. J Neurosurg Spine. 2020;33:507–512.
Keong KM, Aziz I, Yin Wei CC. Prediction of height increment using preoperative radiological parameters following selective thoracic fusion with alternate-level pedicle screw construct in Lenke 1 and 2 adolescent idiopathic scoliosis patients. J Orthop Surg. 2017:25. doi: 10.1177/2309499016684431.
Sarlak AY, Atmaca H, Musaoğlu R, et al. The height gain in scoliotic deformity correction: assessed by new predictive formula. Comput Math Methods Med. 2012;2012:1–7.
Shan G, Zhang H, Jiang T. Correlation coefficients for a study with repeated measures. Comput Math Methods Med. 2020;2020:1–11.
Waldmann P. On the Use of the Pearson Correlation Coefficient for Model Evaluation in Genome-Wide Prediction. Front Genet. 2019;10:899.
Salkind N Encyclopedia of Research Design. Thousand Oaks, CA; SAGE Publications, Inc. 2010. Available at: https://methods.sagepub.com/reference/encyc-of-research-design . Accessed January 5, 2022.
Neill SP, Hashemi MR Ocean modelling for resource characterization. In: Fundamentals of Ocean Renewable Energy . Elsevier; 2018. p. 193–235. Available at: https://linkinghub.elsevier.com/retrieve/pii/B9780128104484000082 . Accessed January 5, 2022.
Cavanaugh JE, Neath AA. The Akaike information criterion: Background, derivation, properties, application, interpretation, and refinements. WIREs Comput Stat. 2019;11:e1460. doi: 10.1002/wics.1460
doi: 10.1002/wics.1460
Bozdogan H. Akaike’s information criterion and recent developments in information complexity. J Math Psychol. 2000;44:62–91.
Glatting G, Kletting P, Reske SN, et al. Choosing the optimal fit function: comparison of the Akaike information criterion and the F-test. Med Phys. 2007;34:4285–4292.
Ludden TM, Beal SL, Sheiner LB. Comparison of the Akaike Information Criterion, the Schwarz criterion and the F test as guides to model selection. J Pharmacokinet Biopharm. 1994;22:431–445.
Portet S. A primer on model selection using the Akaike Information Criterion. Infect Dis Model. 2020;5:111–128.
Geck MJ, Rinella A, Hawthorne D, et al. Comparison of surgical treatment in Lenke 5C adolescent idiopathic scoliosis: anterior dual rod versus posterior pedicle fixation surgery: a comparison of two practices. Spine (Phila Pa 1976). 2009;34:1942–1951.
Jiang H, Shao W, Xu E, et al. Coronal imbalance after selective posterior thoracic fusion in patients with Lenke 1 and 2 adolescent idiopathic scoliosis. Biomed Res Int. 2018;2018:3476425.
Wang Y, Fei Q, Qiu G, et al. Anterior spinal fusion versus posterior spinal fusion for moderate lumbar/thoracolumbar adolescent idiopathic scoliosis: a prospective study. Spine (Phila Pa 1976). 2008;33:2166–2172.