{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:25:40Z","timestamp":1793489140561,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004721","name":"The University of Tokyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004721","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Adult spinal deformity (ASD) is associated with a combination of back and leg pain of various intensities. The objective of the present study was to investigate the diverse reaction of pain profiles following ASD surgery as well as post-operative patient satisfaction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Multicenter surveillance collected data for patients \u2265\u200919 years old who underwent primary thoracolumbar fusion surgery at &gt;\u20095 spinal levels for ASD. Two-step cluster analysis was performed utilizing pre-operative numeric rating scale (NRS) for back and leg pain. Radiologic parameters and patient-reported outcome (PRO) scores were also obtained. One-year post-operative outcomes and satisfaction rates were compared among clusters, and influencing factors were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Based on cluster analysis, 191 ASD patients were categorized into three groups: ClusterNP, mild pain only (n\u2009=\u200955); ClusterBP, back pain only (n\u2009=\u200968); and ClusterBLP, significant back and leg pain (n\u2009=\u200968). ClusterBLP (mean NRS<jats:sub>back<\/jats:sub> 7.6, mean NRS<jats:sub>leg<\/jats:sub> 6.9) was the oldest 73.4\u00a0years (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and underwent interbody fusion (88%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and sacral\/pelvic fixation (69%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) more commonly than the other groups, for the worst pelvis incidence\u2014lumbar lordosis mismatch (mean 43.7\u00b0, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) and the greatest sagittal vertical axis (mean 123\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). While NRS<jats:sub>back<\/jats:sub>, NRS<jats:sub>leg<\/jats:sub> and PRO scores were all improved postoperatively in ClustersBP and BLP, ClusterBLP showed the lowest satisfaction rate (80% vs. 80% vs. 63%, <jats:italic>p<\/jats:italic>\u2009=\u20090.11), which correlated with post-operative NRS<jats:sub>back<\/jats:sub> (rho\u2009=\u2009\u22120.357).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Cluster analysis revealed three clusters of ASD patients, and the cluster with the worst pain back and leg pain had the most advanced disease and showed the lowest satisfaction rate, affected by postoperative back pain.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-024-08350-2","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T09:02:20Z","timestamp":1717664540000},"page":"2804-2812","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Post-operative shift in pain profile following fusion surgery for adult spinal deformity: a cluster analysis"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0835-2724","authenticated-orcid":false,"given":"So","family":"Kato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomu","family":"Ohtomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Matsubayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiro","family":"Takeshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Kodama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Oshina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiro","family":"Higashikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Hara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Tachibana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Oshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The University of Tokyo Spine Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"issue":"34","key":"8350_CR1","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.1097\/BRS.0b013e3181b05146","volume":"1976","author":"S Bess","year":"2009","unstructured":"International Spine Study G, Bess S, Boachie-Adjei O, Burton D, Cunningham M, Shaffrey C, Shelokov A, Hostin R, Schwab F, Wood K, Akbarnia B (2009) Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients. Spine 1976(34):2186\u20132190. https:\/\/doi.org\/10.1097\/BRS.0b013e3181b05146","journal-title":"Spine"},{"issue":"41","key":"8350_CR2","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1097\/BRS.0000000000001202","volume":"1976","author":"S Bess","year":"2016","unstructured":"International Spine Study G, Bess S, Line B, Fu KM, McCarthy I, Lafage V, Schwab F, Shaffrey C, Ames C, Akbarnia B, Jo H, Kelly M, Burton D, Hart R, Klineberg E, Kebaish K, Hostin R, Mundis G, Mummaneni P, Smith JS (2016) The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases. Spine 1976(41):224\u2013233. https:\/\/doi.org\/10.1097\/BRS.0000000000001202","journal-title":"Spine"},{"key":"8350_CR3","doi-asserted-by":"publisher","first-page":"540","DOI":"10.3171\/2014.10.SPINE14475","volume":"22","author":"JK Scheer","year":"2015","unstructured":"International Spine Study G, Scheer JK, Smith JS, Clark AJ, Lafage V, Kim HJ, Rolston JD, Eastlack R, Hart RA, Protopsaltis TS, Kelly MP, Kebaish K, Gupta M, Klineberg E, Hostin R, Shaffrey CI, Schwab F, Ames CP (2015) Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. J Neurosurg Spine 22:540\u2013553. https:\/\/doi.org\/10.3171\/2014.10.SPINE14475","journal-title":"J Neurosurg Spine"},{"key":"8350_CR4","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1097\/BRS.0000000000002633","volume":"43","author":"DT Cawley","year":"2018","unstructured":"Cawley DT, Larrieu D, Fujishiro T, Kieser D, Boissiere L, Acaroglu E, Alanay A, Kleinstuck F, Pellise F, Perez-Grueso FS, Vital JM, Gille O, Obeid I (2018) NRS20: combined back and leg pain score: a simple and effective assessment of adult spinal deformity. Spine 43:1184\u20131192. https:\/\/doi.org\/10.1097\/BRS.0000000000002633","journal-title":"Spine"},{"issue":"44","key":"8350_CR5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/BRS.0000000000002815","volume":"1976","author":"R Verma","year":"2019","unstructured":"International Spine Study G, Verma R, Lafage R, Scheer J, Smith J, Passias P, Hostin R, Ames C, Mundis G, Burton D, Kim HJ, Bess S, Klineberg E, Schwab F, Lafage V (2019) Improvement in back and leg pain and disability following adult spinal deformity surgery: study of 324 patients with 2-year follow-up and the impact of surgery on patient-reported outcomes. Spine 1976(44):263\u2013269. https:\/\/doi.org\/10.1097\/BRS.0000000000002815","journal-title":"Spine"},{"issue":"34","key":"8350_CR6","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1097\/BRS.0b013e3181ac5fcd","volume":"1976","author":"JS Smith","year":"2009","unstructured":"Spinal Deformity Study G, Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, Ondra S, Schwab F, Shainline M, Fu KM, Bridwell K (2009) Operative versus nonoperative treatment of leg pain in adults with scoliosis: a retrospective review of a prospective multicenter database with two-year follow-up. Spine 1976(34):1693\u20131698. https:\/\/doi.org\/10.1097\/BRS.0b013e3181ac5fcd","journal-title":"Spine"},{"key":"8350_CR7","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1227\/01.NEU.0000347005.35282.6C","volume":"65","author":"JS Smith","year":"2009","unstructured":"Spinal Deformity Study G, Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, Ondra S, Schwab F, Shainline M, Fu KM, Bridwell K (2009) Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery 65:86\u201393. https:\/\/doi.org\/10.1227\/01.NEU.0000347005.35282.6C. (discussion 93-84)","journal-title":"Neurosurgery"},{"key":"8350_CR8","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1227\/NEU.0000000000000182o","volume":"74","author":"F Schwab","year":"2014","unstructured":"Schwab F, Blondel B, Chay E, Demakakos J, Lenke L, Tropiano P, Ames C, Smith JS, Shaffrey CI, Glassman S, Farcy JP, Lafage V (2014) The comprehensive anatomical spinal osteotomy classification. Neurosurgery 74:112\u2013120. https:\/\/doi.org\/10.1227\/NEU.0000000000000182o. (discussion 120)","journal-title":"Neurosurgery"},{"key":"8350_CR9","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","volume":"34","author":"J Ware Jr","year":"1996","unstructured":"Ware J Jr, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220\u2013233","journal-title":"Med Care"},{"key":"8350_CR10","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","volume":"16","author":"EuroQol Group","year":"1990","unstructured":"EuroQol Group (1990) EuroQol\u2014a new facility for the measurement of health-related quality of life. Health Policy 16:199\u2013208","journal-title":"Health Policy"},{"key":"8350_CR11","first-page":"271","volume":"66","author":"JC Fairbank","year":"1980","unstructured":"Fairbank JC, Couper J, Davies JB, O\u2019Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271\u2013273","journal-title":"Physiotherapy"},{"key":"8350_CR12","doi-asserted-by":"publisher","first-page":"340","DOI":"10.3171\/2014.12.SPINE141031","volume":"23","author":"S Fakurnejad","year":"2015","unstructured":"International Spine Study G, Fakurnejad S, Scheer JK, Lafage V, Smith JS, Deviren V, Hostin R, Mundis GM Jr, Burton DC, Klineberg E, Gupta M, Kebaish K, Shaffrey CI, Bess S, Schwab F, Ames CP (2015) The likelihood of reaching minimum clinically important difference and substantial clinical benefit at 2 years following a 3-column osteotomy: analysis of 140 patients. J Neurosurg Spine 23:340\u2013348. https:\/\/doi.org\/10.3171\/2014.12.SPINE141031","journal-title":"J Neurosurg Spine"},{"key":"8350_CR13","doi-asserted-by":"publisher","first-page":"E2","DOI":"10.3171\/2017.10.FOCUS17554","volume":"44","author":"AL Asher","year":"2018","unstructured":"Asher AL, Kerezoudis P, Mummaneni PV, Bisson EF, Glassman SD, Foley KT, Slotkin JR, Potts EA, Shaffrey ME, Shaffrey CI, Coric D, Knightly JJ, Park P, Fu KM, Devin CJ, Archer KR, Chotai S, Chan AK, Virk MS, Bydon M (2018) Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the quality outcomes database. Neurosurg Focus 44:E2. https:\/\/doi.org\/10.3171\/2017.10.FOCUS17554","journal-title":"Neurosurg Focus"},{"key":"8350_CR14","doi-asserted-by":"publisher","first-page":"349","DOI":"10.3171\/2014.12.SPINE14777","volume":"23","author":"JS Smith","year":"2015","unstructured":"International Spine Study G, Smith JS, Shaffrey CI, Lafage V, Schwab F, Scheer JK, Protopsaltis T, Klineberg E, Gupta M, Hostin R, Fu KM, Mundis GM Jr, Kim HJ, Deviren V, Soroceanu A, Hart RA, Burton DC, Bess S, Ames CP (2015) Comparison of best versus worst clinical outcomes for adult spinal deformity surgery: a retrospective review of a prospectively collected, multicenter database with 2-year follow-up. J Neurosurg Spine 23:349\u2013359. https:\/\/doi.org\/10.3171\/2014.12.SPINE14777","journal-title":"J Neurosurg Spine"},{"issue":"44","key":"8350_CR15","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1097\/BRS.0000000000002974","volume":"1976","author":"CP Ames","year":"2019","unstructured":"European Spine Study Group ISSG, Ames CP, Smith JS, Pellise F, Kelly M, Alanay A, Acaroglu E, Perez-Grueso FJS, Kleinstuck F, Obeid I, Vila-Casademunt A, Shaffrey CI Jr, Burton D, Lafage V, Schwab F, Shaffrey CI Sr, Bess S, Serra-Burriel M (2019) Artificial intelligence based hierarchical clustering of patient types and intervention categories in adult spinal deformity surgery: towards a new classification scheme that predicts quality and value. Spine 1976(44):915\u2013926. https:\/\/doi.org\/10.1097\/BRS.0000000000002974","journal-title":"Spine"},{"key":"8350_CR16","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1302\/0301-620X.100B4.BJJ-2017-0846.R2","volume":"100","author":"AD Tambe","year":"2018","unstructured":"Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI (2018) Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Joint J 100:415\u2013424. https:\/\/doi.org\/10.1302\/0301-620X.100B4.BJJ-2017-0846.R2","journal-title":"Bone Joint J"},{"key":"8350_CR17","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.spinee.2006.07.015","volume":"7","author":"A Ploumis","year":"2007","unstructured":"Ploumis A, Transfledt EE, Denis F (2007) Degenerative lumbar scoliosis associated with spinal stenosis. Spine J 7:428\u2013436. https:\/\/doi.org\/10.1016\/j.spinee.2006.07.015","journal-title":"Spine J"},{"key":"8350_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2020.6.SPINE20363","volume":"34","author":"Y Ogura","year":"2020","unstructured":"International Spine Study G, Ogura Y, Gum JL, Soroceanu A, Daniels AH, Line B, Protopsaltis T, Hostin RA, Passias PG, Burton DC, Smith JS, Shaffrey CI, Lafage V, Lafage R, Klineberg EO, Kim HJ, Harris A, Kebaish K, Schwab F, Bess S, Ames CP, Carreon LY (2020) Practical answers to frequently asked questions for shared decision-making in adult spinal deformity surgery. J Neurosurg Spine 34:1\u201310. https:\/\/doi.org\/10.3171\/2020.6.SPINE20363","journal-title":"J Neurosurg Spine"},{"key":"8350_CR19","doi-asserted-by":"publisher","first-page":"408","DOI":"10.3171\/2019.2.SPINE181486","volume":"31","author":"K Hayashi","year":"2019","unstructured":"Hayashi K, Boissiere L, Guevara-Villazon F, Larrieu D, Nunez-Pereira S, Bourghli A, Gille O, Vital JM, Pellise F, Sanchez Perez-Grueso FJ, Kleinstuck F, Acaroglu E, Alanay A, Obeid I (2019) Factors influencing patient satisfaction after adult scoliosis and spinal deformity surgery. J Neurosurg Spine 31:408\u2013417. https:\/\/doi.org\/10.3171\/2019.2.SPINE181486","journal-title":"J Neurosurg Spine"},{"key":"8350_CR20","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1016\/j.wneu.2021.08.047","volume":"155","author":"WHA Ryu","year":"2021","unstructured":"Ryu WHA, Cheong M, Platt A, Moses Z, O\u2019Toole JE, Fontes R, Fessler RG (2021) Patient satisfaction following minimally invasive and open surgeries for adult spinal deformity. World Neurosurg 155:e301\u2013e314. https:\/\/doi.org\/10.1016\/j.wneu.2021.08.047","journal-title":"World Neurosurg"},{"key":"8350_CR21","doi-asserted-by":"publisher","first-page":"e931","DOI":"10.1016\/j.wneu.2020.11.035","volume":"146","author":"WHA Ryu","year":"2021","unstructured":"Ryu WHA, Platt A, O\u2019Toole JE, Fontes R, Fessler RG (2021) Patient expectations of adult spinal deformity correction surgery. World Neurosurg 146:e931\u2013e939. https:\/\/doi.org\/10.1016\/j.wneu.2020.11.035","journal-title":"World Neurosurg"},{"key":"8350_CR22","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1007\/s00586-017-5358-2","volume":"27","author":"TF Fekete","year":"2018","unstructured":"Fekete TF, Loibl M, Jeszenszky D, Haschtmann D, Banczerowski P, Kleinstuck FS, Becker HJ, Porchet F, Mannion AF (2018) How does patient-rated outcome change over time following the surgical treatment of degenerative disorders of the thoracolumbar spine? Eur Spine J 27:700\u2013708. https:\/\/doi.org\/10.1007\/s00586-017-5358-2","journal-title":"Eur Spine J"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-024-08350-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-024-08350-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-024-08350-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T22:06:33Z","timestamp":1721858793000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-024-08350-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,6]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["8350"],"URL":"https:\/\/doi.org\/10.1007\/s00586-024-08350-2","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,6]]},"assertion":[{"value":"14 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 June 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"So Kato receives grants from Olympus Terumo Biomaterials. The other authors have no competing interests to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from all participants, and approval for this study was given by the institutional review board of the Clinical Research Support Center at the University of Tokyo.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}