Geographic and Ethnic Variations in Radiographic Disability Thresholds: Analysis of North American and Japanese Operative Adult XXXX .

@entity1 @entity10479 @entity1513 @entity1515 @entity717 @entity85
BACKGROUND: Thresholds for spinal pelvic parameters in @entity85 ( @entity85 ) were previously defined in North American @entity1 and are commonly used to guide surgical planning. However, it is unclear whether these same threshold parameters can be more widely applied in other geographic regions and in other ethnicities. OBJECTIVE: To evaluate the variation in the radiographic disability thresholds between North American and Japanese @entity85 populations and to adjust sagittal modifier thresholds accordingly. METHODS: Retrospective case series of 717 @entity1 with @entity85 who had baseline radiographs and @entity717 Index (ODI) from North America (n = 518) and Japan (n = 199) were studied. @entity1 were compared at baseline for ODI, ODI offset from age- and ethnic-specific values (ODIni), and radiographic parameters. RESULTS: Significant differences in classification were observed: A greater proportion of Japanese @entity1 had marked pelvic @entity85 , whereas a greater proportion of @entity10479 @entity1 had marked @entity85 ; no difference in the pelvic incidence-lumbar @entity1515 mismatch sagittal modifier was observed. Health-related quality-of-life scores also differed, with a greater ODI raw value observed in the @entity10479 @entity1 but similar ODIni scores between cohorts. Stratifying ODIni scores by sagittal modifier grades revealed similar disability scores corresponding to the 0 to + thresholds for pelvic tilt, pelvic incidence-lumbar @entity1515 mismatch, and sagittal vertical axis across ethnicities. Finally, linear regression analysis demonstrated that compared with @entity10479 @entity1 , Japanese @entity1 had a lower estimated ODI corresponding to established thresholds of @entity85 . CONCLUSION: Our findings demonstrate significant variability in health-related quality-of-life measures and radiographic parameters between North American and Japanese @entity1 , supporting the need for population-adjusted sagittal modifiers to more accurately classify @entity85 . ABBREVIATIONS: @entity85 , adult spinal deformityHRQOL, health-related quality of lifeLL, lumbar lordosisODI, @entity717 IndexODIni, @entity717 Index need for improvementPCS, physical component summaryPI, pelvic incidencePI-LL, pelvic incidence-lumbar @entity1515 mismatchPT, pelvic tiltSRS, Scoliosis Research SocietySVA, sagittal vertical axisTK, @entity1513 .
