Adult Spinal Deformity

Adult Spinal Deformity Correction | Prof Buckland

Patient Outcome Data

As part of your standard of care, Prof Buckland gathers patient reported outcomes (PROs) in order to ensure we gain clear insights into the success rates of our surgeries. By sharing real patient experiences and outcomes, we aim to build trust and confidence in our procedures, helping you make informed decisions about your healthcare journey. This data not only aids in continuous improvement but also guides others towards achieving their best possible outcomes.

Disclaimer: The results presented herein are representative only of Prof Buckland’s surgical outcomes and experiences. They are specific to the techniques and practices of Prof Buckland and cannot be generalized to represent the results of other surgeons. Individual patients’ outcomes may vary based on a variety of factors, including but not limited to the specific methods used, patient health conditions, and procedural circumstances.

Functional and Pain Scores Over Time

	Preoperative	3 Month Follow-up	1 Year Follow-up	2 Year Follow-up
ODI	50.5	34.2	29.1	26.6
Back Pain ( /10)	7.2	2.4	3.4	3.4
Leg Pain ( /10)	4.9	2.7	3.2	3.2

Interpretation of ODI scores

0 to 20: minimal disability: The patient can cope with most living activities. Usually no treatment is indicated apart from advice on lifting, sitting, and exercise.
21-40: moderate disability: The patient experiences more pain and difficulty with sitting, lifting, and standing. Travel and social life may be affected.
41-60: severe disability: Pain remains the main problem in this group, but activities of daily living are affected. These patients require a detailed investigation.
61-80: crippled: Back pain impinges on all aspects of the patient’s life. Positive intervention is required.
81-100: These patients are either bed-bound or exaggerating their symptoms.

Likelihood of Improvement

<h2>Likelihood of Improvement</h2>

How do we measure clinical improvement?

Clinical benefit is measured by the ‘Minimally Clinically Important Difference’ (MCID). This measurement is used to determine the change in function that a patient would recognize as beneficial and meaningful.

MCID is measured as an improvement in Oswestry Disability Index (ODI) of more than 12.8%¹

1. Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and Pain Scales. The Spine Journal. 2008;8(6):968-974

SRS-22r Questionnaire Outcomes

Post-Surgery Management Satisfaction

Customer Satisfaction Pie Charts

Interpretation of Scoliosis Outcome Measures

The Scoliosis Research Society‑22 Revised (SRS‑22r) is a questionnaire used to evaluate the quality of life for individuals with scoliosis. It includes 22 questions divided into several categories that assess different aspects of a patient’s well‑being. Here’s how to interpret the scores in simple terms:

Domains

1. Function/Activity: Measures how well the person can perform daily activities.

2. Pain: Assesses the level of pain experienced by the person.

3. Self‑Image/Appearance: Evaluates how the person feels about their appearance.

4. Mental Health: Looks at the person’s emotional and psychological well‑being.

5. Satisfaction with Management: Gauges how satisfied the person is with their treatment.

Scoring

Each question is scored on a scale from 1 to 5:

• 1: Worst outcome (e.g., severe pain, very limited activity, very dissatisfied)
• 5: Best outcome (e.g., no pain, no limitations, very satisfied)

Complication Rates

Prof. Buckland’s complication rates are published here online for transparency and to add to the process of Informed Consent. While Prof. Buckland regularly publishes his complication rates in peer-reviewed medical journals, this is not readily available to patients. His goal is to help patients make informed decisions based on real data, and he believes in the importance of sharing this information openly.

HCF Health Insurance is currently the only Australian insurer that publishes their Complication Rates online, providing a helpful benchmark for patients to understand general trends in surgical outcomes. These figures are taken from multiple sources, from local and international publications, and represent an average across various surgeons and hospitals. While useful, they may not capture the nuances of individual surgical practices.

Complication	Reference Range (%)	Prof Buckland (%)
Dural Tear	3 - 4.1%	3.2%
Reoperation for Spinal Fluid Leak	0.2%	0.0%
2Yr Revision Surgery Rate - All Causes	15.9 - 23.9%	11.9%
Further Decompression	Not Reported	0.0%
Wound Dehiscence (No Infection)	1.2%	2.2%
Surgical Site Infection	2.6 - 3.2%	1.2%
Rob Breakage / Failure of Fusion	5.4 - 11.9%	1.2%
Adjacent Segment Disease	2.7%	3.0%
Proximal Junctional Kyphosis / Failure	13 - 55%	4.5%
Distal Junctional Kyphosis / Failure	6.3%	0.0%
Screw Repositioning	0 - 8.3%	1.2%
Vascular Injury	0 - 10.9%	3.0%
Nerve Root Injury	3.1%	1.2%
Spinal Cord Injury	Not Reported	0.0%
Pulmonary Embolus	2.1%	1.5%
Deep Vein Thrombosis (DVT)y	0.5% – 1.9%	1.5%
Blindness	0.04%	0.0%
Postoperative Bleeding	Not Reported	0.0%
Transfusion	41 - 60%	22.0%

Reference Range is extracted from the following high quality and large volume studies^1,2,3

1. Smith JS, Lafage V, Shaffrey CI, Schwab F, Lafage R, Hostin R, OʼBrien M, Boachie-Adjei O, Akbarnia BA, Mundis GM, Errico T, Kim HJ, Protopsaltis TS, Hamilton DK, Scheer JK, Sciubba D, Ailon T, Fu KM, Kelly MP, Zebala L, Line B, Klineberg E, Gupta M, Deviren V, Hart R, Burton D, Bess S, Ames CP; International Spine Study Group. Outcomes of Operative and Nonoperative Treatment for Adult Spinal Deformity: A Prospective, Multicenter, Propensity-Matched Cohort Assessment With Minimum 2-Year Follow-up. Neurosurgery. 2016 Jun;78(6):851-61. doi: 10.1227/NEU.0000000000001116. PMID: 26579966.

2. Sciubba DM, Yurter A, Smith JS, Kelly MP, Scheer JK, Goodwin CR, Lafage V, Hart RA, Bess S, Kebaish K, Schwab F, Shaffrey CI, Ames CP; International Spine Study Group (ISSG). A Comprehensive Review of Complication Rates After Surgery for Adult Deformity: A Reference for Informed Consent. Spine Deform. 2015 Nov;3(6):575-594. doi: 10.1016/j.jspd.2015.04.005. Epub 2015 Oct 28. PMID: 27927561.

3. Lafage R, Bass RD, Klineberg E, Smith JS, Bess S, Shaffrey C, Burton DC, Kim HJ, Eastlack R, Mundis G Jr, Ames CP, Passias PG, Gupta M, Hostin R, Hamilton K, Schwab F, Lafage V; International Spine Study Group. Complication Rates Following Adult Spinal Deformity Surgery: Evaluation of the Category of Complication and Chronology. Spine (Phila Pa 1976). 2024 Jun 15;49(12):829-839. doi: 10.1097/BRS.0000000000004969. Epub 2024 Feb 20. PMID: 38375636.

Ready to take the next step? Contact our expert team today to schedule a consultation and explore your treatment options for adult spinal deformity correction.

Outcomes Analysed to Provide Comprehensive Insights