{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:39:50Z","timestamp":1792636790158,"version":"4.5.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective was to evaluate factors associated with the long-term durability of outcomes in adult spinal deformity (ASD) patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Operative ASD patients fused from at least L1 to the sacrum with baseline (BL) to 5-year (5Y) follow-up were included. Substantial clinical benefit (SCB) in Oswestry Disability Index (ODI), numeric rating scale (NRS)\u2013back, NRS-leg, and Scoliosis Research Society (SRS)\u201322r scores and physical component score were assessed on the basis of previously published values. Factors were evaluated on the basis of meeting optimal outcomes (OO) at 2 years (2+) and 5 years (5+). Furthermore, 2+ patients were isolated and evaluated on the basis of meeting OO at 5 years (2+5+) or not at 5 years (2+5\u2212). OO were defined as follows: no reoperation, major mechanical failure, proximal junctional failure, and meeting either 1) SCB in terms of ODI score (decrease &gt; 18.8) or 2) ODI &lt; 15 and SRS-22r total &gt; 4.5.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In total, 330 ASD patients met the inclusion criteria, with 45.5% meeting SCB for ODI at 2 years, while 46.0% met SCB at 5 years; 79% of those who achieved 2-year (2Y) SCB went on to achieve 5Y SCB. This rate was lower for OO, with 41% achieving 2Y OO (2+), while 37% met 5Y OO (5+) and 80% of 2+ patients had durable outcomes until 5+ (32% of the total cohort). Of the patient factors, frailty was significantly different among groups at 2 years, while comorbidity burden was significantly different at 5 years and the combination thereof differed in those with durable outcomes. Those who regained their level of activity postoperatively had 4 times higher odds of maintaining OO from 2 years to 5 years (p &lt; 0.05). Osteoporosis rates, although equivocal at BL, were higher at the last follow-up in those who met 2Y OO but failed to meet 5Y OO. The odds of achieving OO at 5 years in 2+ patients decreased by 47% for each additional comorbidity and decreased by 74% in those who had lower-extremity paresthesias at BL (both p &lt; 0.05). Controlling for patient factors and BL disability found fewer levels fused, decreased correction of sagittal vertical axis, and increased correction of pelvic incidence\u2013lumbar lordosis mismatch to be predictive of maintaining 2Y OO until 5 years (p &lt; 0.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>SCB was met in 46% of ASD patients at 5 years. The durability of OO was seen in a third of patients until 5 years postoperatively. Higher rates of medical complications were seen in those who failed to achieve and maintain OO until 5 years. Frailty and comorbidity burden were significant factors associated with the achievement and durability of OO until 5 years.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.5.spine2456","type":"journal-article","created":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T01:51:15Z","timestamp":1725069075000},"page":"765-773","source":"Crossref","is-referenced-by-count":6,"title":["Durability of substantial clinical benefit leading to optimal outcomes in adult spinal deformity corrective surgery: a minimum 5-year analysis"],"prefix":"10.3171","volume":"41","author":[{"given":"Jamshaid M.","family":"Mir","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Galetta","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nima","family":"Alan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California San Francisco Medical Center, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwatobi O.","family":"Onafowokan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Dave","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tretiakov","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan A.","family":"Lorentz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel","family":"Diebo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Burhan","family":"Janjua","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Lenox Hill Hospital, Northwell Health, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Schoenfeld","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Sciubba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas K.","family":"Demetriades","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Edinburgh Spinal Surgery Outcome Studies Group, Royal Infirmary, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Passias","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, Division of Spine Surgery, NYU Langone Medical Center, New York Spine Institute, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"224","article-title":"The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases","volume":"41","author":"Bess S","year":"2016","unstructured":"Bess S, Line B, Fu KM,  The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases. 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