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Tropp, Hans
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Publications (10 of 41) Show all publications
Vavruch, L., Brink, R. C., Malmqvist, M., Schlösser, T. P. .., van Stralen, M., Abul-Kasim, K., . . . Tropp, H. (2019). Surgical Outcomes of Anterior Versus Posterior Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis. Spine, 44(14), E823-E832
Open this publication in new window or tab >>Surgical Outcomes of Anterior Versus Posterior Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis
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2019 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 44, no 14, p. E823-E832Article in journal (Refereed) Published
Abstract [en]

Mini Patients with Lenke type 1 idiopathic scoliosis can be effectively managed surgically with an anterior or posterior approach. However, each approach has specific advantages and challenges, as described in this study, which must be considered before treating each patient.

Study Design. Retrospective study.

Objective. To describe surgical results in two and three dimensions and patient-reported outcomes of scoliosis treatment for Lenke type 1 idiopathic curves with an open anterior or posterior approach.

Summary of Background Data. Different surgical techniques have been described to prevent curve progression and to restore spinal alignment in idiopathic scoliosis. The spine can be accessed via an anterior or a posterior approach. However, the surgical outcomes, especially in three dimensions, for different surgical approaches remain unclear.

Methods. Cohorts of Lenke curve type 1 idiopathic scoliosis patients, after anterior or posterior spinal fusion were recruited, to measure curve characteristics on conventional radiographs, before and after surgery and after 2 years follow-up, whereas the vertebral axial rotation, true mid-sagittal anterior–posterior height ratio of individual structures, and spinal height differences were measured on 3D reconstructions of the pre- and postoperative supine low-dose computed tomography (CT) scans. Additionally, the intraoperative parameters were described and the patients completed the SRS-22 and EQ-5D-3L questionnaire postoperatively.

Results. Fifty-three patients with Lenke curve type 1 idiopathic scoliosis (26 in the anterior cohort and 27 in the posterior cohort) were analyzed. Fewer vertebrae were instrumented in the anterior cohort compared with the posterior cohort (P < 0.001), with less surgery time and lower intraoperative blood loss (P < 0.001). The Cobb angle correction of the primary thoracic curve directly after surgery was 57 ± 12% in the anterior cohort and 73 ± 12% in the posterior cohort (P < 0.001) and 55 ± 13% and 66 ± 12% (P = 0.001) at 2 years follow-up. Postoperative 3D alignment restoration and questionnaires showed no significant differences between the cohorts.

Conclusion. This study suggests that Lenke type 1 curves can be effectively managed surgically with either an open anterior or posterior approach. Each approach, however, has specific advantages and challenges, as described in this study, which must be considered before treating each patient.

Level of evidence: 3

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-154283 (URN)10.1097/brs.0000000000002984 (DOI)000480757200003 ()30664096 (PubMedID)
Note

Funding agencies:  Swedish Society of Spinal Surgeons funds

Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-09-06Bibliographically approved
Brink, R. C., Vavruch, L., Schlösser, T. P. C., Abul-Kasim, K., Ohlin, A., Tropp, H., . . . Vrtovec, T. (2019). Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls. European spine journal, 28(3), 544-550
Open this publication in new window or tab >>Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls
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2019 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 28, no 3, p. 544-550Article in journal (Refereed) Published
Abstract [en]

Purpose

The pelvic incidence (PI) is used to describe the sagittal spino-pelvic alignment. In previous studies, radiographs were used, leading to less accuracy in establishing the three-dimensional (3D) spino-pelvic parameters. The purpose of this study is to analyze the differences in the 3D sagittal spino-pelvic alignment in adolescent idiopathic scoliosis (AIS) subjects and non-scoliotic controls.

Methods

Thirty-seven female AIS patients that underwent preoperative supine low-dose computed tomography imaging of the spine, hips and pelvis as part of their general workup were included and compared to 44 non-scoliotic age-matched female controls. A previously validated computerized method was used to measure the PI in 3D, as the angle between the line orthogonal to the inclination of the sacral endplate and the line connecting the center of the sacral endplate with the hip axis.

Results

The PI was on average 46.8° ± 12.4° in AIS patients and 41.3° ± 11.4° in controls (p = 0.025), with a higher PI in Lenke type 5 curves (50.6° ± 16.2°) as compared to controls (p = 0.042), whereas the Lenke type 1 curves (45.9° ± 12.2°) did not differ from controls (p = 0.141).

Conclusion

Lenke type 5 curves show a significantly higher PI than controls, whereas the Lenke type 1 curves did not differ from controls. This suggests a role of pelvic morphology and spino-pelvic alignment in the pathogenesis of idiopathic scoliosis. Further longitudinal studies should explore the exact role of the PI in the initiation and progression of different AIS types.

Place, publisher, year, edition, pages
Heidelberg: Springer, 2019
Keywords
Idiopathic scoliosis, Sagittal alignment, Pelvic incidence, Three-dimensional analysis, Computed tomography
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-152573 (URN)10.1007/s00586-018-5718-6 (DOI)000461290800010 ()30128762 (PubMedID)2-s2.0-85051834138 (Scopus ID)
Note

Funding agencies: K2M; Alexandre Suerman Md/PhD grant; Swedish Society of Spinal surgeons

Available from: 2018-11-07 Created: 2018-11-07 Last updated: 2019-04-01Bibliographically approved
Daghighi, A., Tropp, H., Dahlström, N. & Klarbring, A. (2018). Correction: F.E.M. Stress-Investigation of Scolios Apex. Open Biomedical Engineering Journal, 12, 51-71
Open this publication in new window or tab >>Correction: F.E.M. Stress-Investigation of Scolios Apex
2018 (English)In: Open Biomedical Engineering Journal, ISSN 1874-1207, E-ISSN 1874-1207, Vol. 12, p. 51-71Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Sharjah, United Arab Emirates: Bentham Open, 2018
National Category
Computer Engineering
Identifiers
urn:nbn:se:liu:diva-156039 (URN)10.2174/1874120701812010090 (DOI)30450136 (PubMedID)2-s2.0-85056615684 (Scopus ID)
Available from: 2019-04-02 Created: 2019-04-02 Last updated: 2019-06-28Bibliographically approved
Daghighi, A., Tropp, H., Dahlström, N. & Klarbring, A. (2018). F.E.M. Stress-Investigation of Scolios Apex. Open Biomedical Engineering Journal, 12, 51-71
Open this publication in new window or tab >>F.E.M. Stress-Investigation of Scolios Apex
2018 (English)In: Open Biomedical Engineering Journal, ISSN 1874-1207, E-ISSN 1874-1207, Vol. 12, p. 51-71Article in journal (Refereed) Published
Abstract [en]

In scoliosis, kypholordos and wedge properties of the vertebrae should be involved in determining how stress is distributed in the vertebral column. The impact is logically expected to be maximal at the apex.

Place, publisher, year, edition, pages
Bentham Open, 2018
Keywords
Comsol model; FEM Stress-Investigation; Mechanical loading; Pathological mechanisms; Scoliosis; Thoracal Idiopathic
National Category
Computer Engineering
Identifiers
urn:nbn:se:liu:diva-152506 (URN)10.2174/1874120701812010051 (DOI)30258499 (PubMedID)
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-10-07
Lindbäck, Y., Tropp, H., Enthoven, P., Abbott, A. & Öberg, B. (2018). PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial. The spine journal, 18(8), 1347-1355
Open this publication in new window or tab >>PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial
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2018 (English)In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 8, p. 1347-1355Article in journal (Refereed) Published
Abstract [en]

Background Context

Surgery because of disc herniation or spinal stenosis results mostly in large improvement in the short-term, but mild to moderate improvements for pain and disability at long-term follow-up. Prehabilitation has been defined as augmenting functional capacity before surgery, which may have beneficial effect on outcome after surgery.

Purpose

The aim was to study if presurgery physiotherapy improves function, pain, and health in patients with degenerative lumbar spine disorder scheduled for surgery.

Study Design

A single-blinded, two-arm, randomized controlled trial (RCT).

Patient Sample

A total of 197 patients were consecutively included at a spine clinic. The inclusion criteria were patients scheduled for surgery because of disc herniation, spinal stenosis, spondylolisthesis, or degenerative disc disease (DDD), 25–80 years of age.

Outcome Measures

Primary outcome was Oswestry Disability Index (ODI). Secondary outcomes were pain intensity, anxiety, depression, self-efficacy, fear avoidance, physical activity, and treatment effect.

Methods

Patients were randomized to either presurgery physiotherapy or standardized information, with follow-up after the presurgery intervention as well as 3 and 12 months post surgery. The study was funded by regional research funds for US$77,342. No conflict of interest is declared.

Results

The presurgery physiotherapy group had better ODI, visual analog scale (VAS) back pain, EuroQol-5D (EQ-5D), EQ-VAS, Fear Avoidance Belief Questionnaire-Physical Activity (FABQ-PA), Self-Efficacy Scale (SES), and Hospital Anxiety and Depression Scale (HADS) depression scores and activity level compared with the waiting-list group after the presurgery intervention. The improvements were small, but larger than the study-specific minimal clinical important change (MCIC) in VAS back and leg pain, EQ-5D, and FABQ-PA, and almost in line with MCIC in ODI and Physical Component Summary (PCS) in the physiotherapy group. Post surgery, the only difference between the groups was higher activity level in the physiotherapy group compared with the waiting-list group.

Conclusions

Presurgery physiotherapy decreases pain, risk of avoidance behavior, and worsening of psychological well-being, and improves quality of life and physical activity levels before surgery compared with waiting-list controls. These results were maintained only for activity levelspost surgery. Still, presurgery selection, content, dosage of exercises, and importance of being active in a presurgery physiotherapy intervention is of interest to study further to improve long-term outcome.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Disc herniation, Function, Physiotherapy, Spinal stenosis, Stratification, Surgery
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-147620 (URN)10.1016/j.spinee.2017.12.009 (DOI)000443585000006 ()29253630 (PubMedID)2-s2.0-85044627865 (Scopus ID)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2019-05-01Bibliographically approved
Vavruch, L., Forsberg, D., Dahlström, N. & Tropp, H. (2018). Vertebral Axial Asymmetry in Adolescent Idiopathic Scoliosis.. Spine Deformity, 6(2), 112-120.e1
Open this publication in new window or tab >>Vertebral Axial Asymmetry in Adolescent Idiopathic Scoliosis.
2018 (English)In: Spine Deformity, ISSN 2212-134X, Vol. 6, no 2, p. 112-120.e1Article in journal (Refereed) Published
Abstract [en]

Study Design

Retrospective study.

Objectives

To investigate parameters of axial vertebral deformation in patients with scoliosis compared to a control group, and to determine whether these parameters correlated with the severity of spine curvature, measured as the Cobb angle.

Summary of Background Data

Adolescent idiopathic scoliosis (AIS) is the most common type of spinal deformity. Many studies have investigated vertebral deformation, in terms of wedging and pedicle deformations, but few studies have investigated actual structural changes within vertebrae.

Methods

This study included 20 patients with AIS (Lenke 1–3, mean age: 15.6 years, range: 11–20). We compared preoperative low-dose computed tomography(CT) examinations of patients with AIS to those of a control group matched for age and sex. The control individuals had no spinal deformity, but they were admitted to the emergency department for trauma CTs. We measured the Cobb angles and the axial vertebral rotation (AVR), axial vertebral bodyasymmetry (AVBA), and frontal vertebral body rotation (FVBR) for the superior end, inferior end, and apical vertebrae, with in-house–developed software. Correlations between entities were investigated with the Pearson correlation test.

Results

The average Cobb angles were 49.3° and 1.3° for the scoliotic and control groups, respectively. The patient and control groups showed significant differences in the AVRs of all three vertebra levels (p < .01), the AVBAs of the superior end and apical vertebrae (p < .008), and the FVBR of the apical vertebra (p = .011). Correlations were only found between the AVBA and FVBR in the superior end vertebra (r = 0.728, p < .001) and in the apical vertebra (r = 0.713, p < .001).

Conclusions

Compared with controls, patients with scoliosis showed clear morphologic differences in the midaxial plane vertebrae. Differences in AVR, AVBA, and FVBR were most pronounced at the apical vertebra. The FVBR provided valuable additional information about the internal rotation and deformation of vertebrae.

Level of Evidence

Level III.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Scoliosis; Morphology; Three-dimensional; Vertebral rotation; Low-dose CT
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-145864 (URN)10.1016/j.jspd.2017.09.001 (DOI)29413732 (PubMedID)2-s2.0-85032338953 (Scopus ID)
Available from: 2018-03-20 Created: 2018-03-20 Last updated: 2019-05-01Bibliographically approved
Lindbäck, Y., Tropp, H., Enthoven, P., Gerdle, B., Abbott, A. & Öberg, B. (2017). Altered somatosensory profile according to quantitative sensory testing in patients with degenerative lumbar spine disorders scheduled for surgery. BMC Musculoskeletal Disorders, 18, Article ID 264.
Open this publication in new window or tab >>Altered somatosensory profile according to quantitative sensory testing in patients with degenerative lumbar spine disorders scheduled for surgery
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2017 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, article id 264Article in journal (Refereed) Published
Abstract [en]

Background: Somatosensory profiling in affected and non-affected body regions can strengthen our insight regarding the underlying pain mechanisms, which can be valuable in treatment decision making and to improve outcomes, in patients with degenerative lumbar spine disorders pre-surgery. The aim was to describe somatosensory profiles in patients with degenerative lumbar spine disorders, to identify the proportion with altered somatosensory profile, and to analyze demographic characteristics, self-reported function, pain, and health pre- and 3 months post-surgery. Methods: In this prospective cohort study in a Spine Clinic, 105 patients scheduled for surgery for spinal stenosis, disc herniation, degenerative disc disease, or spondylolisthesis were consecutively recruited. Exclusion criteria were; indication for acute surgery or previous surgery at the same spinal level or severe grade of pathology. Quantitative sensory testing (QST) and self-reported function, pain, and health was measured pre- and 3 months post-surgery. The somatosensory profile included cold detection threshold, warmth detection threshold, cold pain threshold, heat pain threshold and pressure pain threshold in affected and non-affected body regions. Results: On a group level, the patients somatosensory profiles were within the 95% confidence interval (CI) from normative reference data means. On an individual level, an altered somatosensory profile was defined as having two or more body regions (including a non-affected region) with QST values outside of normal ranges for reference data. The 23 patients (22%) with altered somatosensory profiles, with mostly loss of function, were older (P = 0.031), more often female (P = 0.005), had higher back and leg pain (P = 0.016, 0.020), lower mental health component summary score (SF 36 MCS) (P = 0.004) and larger pain distribution (P = 0.047), compared to others in the cohort. Post-surgery there was a tendency to worse pain, function and health in the group with altered somatosensory profile pre-surgery. Conclusions: On a group level, patients with degenerative lumbar spine disorders scheduled for surgery were within normal range for the QST measurements compared to reference values. On an individual level, an altered somatosensory profile outside of normal range in both affected and non-affected body regions occurred in 22% of patients, which may indicate disturbed somatosensory function. Those patients had mostly loss of sensory function and had worse self-reported outcome pre-surgery, compared to the rest of the cohort. Future prospective studies are needed to further examine whether these dimensions can be useful in predicting post-surgery outcome and guide need of additional treatments.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Disc herniation; Spinal stenosis; Spondylolisthesis; Degenerative disc disease; Spine surgery; Quantitative sensory testing; Outcome
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-139285 (URN)10.1186/s12891-017-1581-6 (DOI)000403494900001 ()28623897 (PubMedID)
Note

Funding Agencies|Swedish Research Council [521-2019-3578]; Faculty of Medicine and Health, Linkoping University; County Council of Ostergotland, Linkoping, Sweden

Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2018-08-28
Brink, R. C., Schlosser, T. P. C., Colo, D., Vavruch, L., van Stralen, M., Vincken, K. L., . . . Castelein, R. M. (2017). Anterior Spinal Overgrowth Is the Result of the Scoliotic Mechanism and Is Located in the Disc. Spine, 42(11), 818-822
Open this publication in new window or tab >>Anterior Spinal Overgrowth Is the Result of the Scoliotic Mechanism and Is Located in the Disc
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2017 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 11, p. 818-822Article in journal (Refereed) Published
Abstract [en]

Study Design. Cross-sectional study. Objective. To investigate the presence and magnitude of anterior spinal overgrowth in neuromuscular scoliosis and compare this with the same measurements in idiopathic scoliosis and healthy spines. Summary of Background Data. Anterior spinal overgrowth has been described as a potential driver for the onset and progression of adolescent idiopathic scoliosis (AIS). Whether this anterior overgrowth is specific for AIS or also present in nonidiopathic scoliosis has not been reported. Methods. Supine computed tomography (CT) scans of thirty AIS patients (thoracic Cobb 21-81 degrees), thirty neuromuscular (NM) scoliotic patients (thoracic Cobb 19-101 degrees) and 30 nonscoliotic controls were used. The difference in length in per cents between the anterior and posterior side {[(Delta A-P)/P] * 100%, abbreviated to A-P%} of each vertebral body and intervertebral disc, and between the anterior side of the spine and the spinal canal (A-C%) were determined. Results. The A-P% of the thoracic curves did not differ between the AIS (+1.2 perpendicular to 2.2%) and NM patients (+0.9 +/- 4.1%, P = 0.663), both did differ, however, from the same measurements in controls (-3.0 +/- 1.6%; Pamp;lt; 0.001) and correlated linearly with the Cobb angle (AIS r = 0.678, NM r = 0.687). Additional anterior length was caused by anterior elongation of the discs (AIS: A-P% disc +17.5 +/- 12.7% vs. A-P% body - 2.5 +/- 2.6%; Pamp;lt; 0.001, NM: A-P% disc + 19.1 +/- 18.0% vs. A-P% body -3.5 +/- 5.1%; Pamp;lt; 0.001). The A-C% T1-S1 in AIS and NM patients were similar (+ 7.9 +/- 1.8% and + 8.7 +/- 4.0%, P = 0.273), but differed from the controls (+4.2 +/- 3.3%; Pamp;lt; 0.001). Conclusion. So called anterior overgrowth has been postulated as a possible cause for idiopathic scoliosis, but apparently it occurs in scoliosis with a known origin as well. This suggests that it is part of a more generalized scoliotic mechanism, rather than its cause. The fact that the intervertebral discs contribute more to this increased anterior length than the vertebral bodies suggests an adaptation to altered loading, rather than a primary growth disturbance.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2017
Keywords
anterior overgrowth; computed tomography; idiopathic scoliosis; neuromuscular scoliosis
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-138478 (URN)10.1097/BRS.0000000000001919 (DOI)000402062900012 ()27683977 (PubMedID)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-11-23
Lindbäck, Y., Tropp, H., Enthoven, P., Gerdle, B., Abbott, A. & Öberg, B. (2017). Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.. European spine journal, 26(10), 2581-2588
Open this publication in new window or tab >>Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.
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2017 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 26, no 10, p. 2581-2588Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre- and post-surgery in patients with disc herniation or spinal stenosis.

METHODS: This is a prospective cohort study with 82 patients. Associations between pressure-, cold- and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre- and three months post-surgery; were investigated with linear regression.

RESULTS: Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and self-efficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain post-surgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs.

CONCLUSIONS: Altered pain response in pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and self-efficacy post-surgery in patients with disc herniation.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Disc herniation, Quantitative sensory testing, Spinal stenosis, Spinal surgery, Widespread pain
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-136688 (URN)10.1007/s00586-017-4979-9 (DOI)000412841000013 ()28168345 (PubMedID)2-s2.0-85011710070 (Scopus ID)
Note

Funding agencies: Swedish Research Council [521-2019-3578]; Faculty of Medicine and Health, Linkoping University; County Council of Ostergotland, Linkoping, Sweden

Available from: 2017-05-12 Created: 2017-05-12 Last updated: 2018-08-27Bibliographically approved
De Kleuver, M., Faraj, S. S. A., Holewijn, R. M., Germscheid, N. M., Adobor, R. D., Andersen, M., . . . Haanstra, T. M. (2017). Defining a core outcome set for adolescent and young adult patients with a spinal deformity A collaborative effort for the Nordic Spine Surgery Registries. Acta Orthopaedica, 88(6), 612-618
Open this publication in new window or tab >>Defining a core outcome set for adolescent and young adult patients with a spinal deformity A collaborative effort for the Nordic Spine Surgery Registries
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2017 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 88, no 6, p. 612-618Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Routine outcome measurement has been shown to improve performance in several fields of healthcare. National spine surgery registries have been initiated in 5 Nordic countries. However, there is no agreement on which outcomes are essential to measure for adolescent and young adult patients with a spinal deformity. The aim of this study was to develop a core outcome set (COS) that will facilitate benchmarking within and between the 5 countries of the Nordic Spinal Deformity Society (NSDS) and other registries worldwide. Material and methods - From August 2015 to September 2016, 7 representatives (panelists) of the national spinal surgery registries from each of the NSDS countries participated in a modified Delphi study. With a systematic literature review as a basis and the International Classification of Functioning, Disability and Health framework as guidance, 4 consensus rounds were held. Consensus was defined as agreement between at least 5 of the 7 representatives. Data were analyzed qualitatively and quantitatively. Results - Consensus was reached on the inclusion of 13 core outcome domains: "satisfaction with overall outcome of surgery", "satisfaction with cosmetic result of surgery", "pain interference", physical functioning", "health-related quality of life", "recreation and leisure", "pulmonary fatigue", "change in deformity", "selfimage", "pain intensity", "physical function", "complications", and "re-operation". Panelists agreed that the SRS-22r, EQ-5D, and a pulmonary fatigue questionnaire (yet to be developed) are the most appropriate set of patient-reported measurement instruments that cover these outcome domains. Interpretation - We have identified a COS for a large subgroup of spinal deformity patients for implementation and validation in the NSDS countries. This is the first study to further develop a COS in a global perspective.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2017
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-143747 (URN)10.1080/17453674.2017.1371371 (DOI)000416605900010 ()28914116 (PubMedID)
Note

Funding Agencies|AOSpine through AOSpine knowledge forum deformity

Available from: 2017-12-15 Created: 2017-12-15 Last updated: 2018-05-03
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