Asher Marc, Lai Sue Min, Burton Doug, Manna Barbara
Department of Orthopedic Surgery, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas 66160-7387, USA.
Spine (Phila Pa 1976). 2004 Apr 15;29(8):861-8. doi: 10.1097/00007632-200404150-00008.
Retrospective case series.
To determine the influence of spine and trunk deformity on preoperative idiopathic scoliosis patients' health-related quality of life questionnaire responses.
Management recommendations for patients with idiopathic scoliosis during adolescence are based heavily on spine deformity and to some extent trunk deformity magnitude. However, the manner in which these objective measures influence the patients' perception of their condition is unclear.
Of 67 consecutive preoperative patients, 61 (91%) had completed the Scoliosis Research Society-22 health-related quality of life questionnaire and had been studied with posterior exposure surface topography. Their average age was 15 years, 6 months (range 10 years, 10 months-20 years, 10 months), and the average maximum Cobb was 63 degrees (range 40-137 degrees). Correlations between spine and trunk deformity measures and Scoliosis Research Society-22 scores were determined by the Pearson correlation coefficient, with P < 0.01 considered significant.
For the study group, spine deformity (Cobb) correlated significantly only with Scoliosis Research Society-22 function (r = -0.39, P = 0.0022) domain. Neither coronal nor transverse plane trunk deformity composite scores correlated with any Scoliosis Research Society-22 scores. The Hump Index component of the transverse plane Suzuki Hump Sum composite score was the only trunk measurement to correlate significantly (function r = -0.45, P = 0.003; self image, r = -0.36, P = 0.0040). The strongest correlations occurred when the single thoracic curves, King classifications III and IV, were combined: Cobb versus function r = -0.53, P = 0.0027; Cobb versus self-image r = -0.46, P = 0.0099; and Hump Index versus function r = -0.60, P = 0.0005. There were no significant correlations between either spine deformity or any trunk deformity measure with Scoliosis Research Society-22 responses for either the double or thoracolumbar curve pattern groups.
Both spine and upper thoracic transverse plane trunk deformity significantly influenced preoperative idiopathic scoliosis patients' perception of function and self-image, but not pain or mental health. However, in spite of a fairly rigorous standard of proof, P < or = 0.01, the significant r values ranged from -0.33 to -0.68, suggesting that there are factors other than spine and trunk deformity influencing the idiopathic scoliosis patients' health-related quality of life questionnaire responses. Future studies are necessary to define these factors.
回顾性病例系列研究。
确定脊柱和躯干畸形对特发性脊柱侧弯术前患者健康相关生活质量问卷回答的影响。
青少年特发性脊柱侧弯患者的治疗建议很大程度上基于脊柱畸形，在一定程度上也基于躯干畸形的程度。然而，这些客观指标影响患者对自身病情认知的方式尚不清楚。
在67例连续的术前患者中，61例（91%）完成了脊柱侧弯研究协会-22健康相关生活质量问卷，并接受了后路暴露表面地形学研究。他们的平均年龄为15岁6个月（范围10岁10个月至20岁10个月），平均最大Cobb角为63度（范围40 - 137度）。通过Pearson相关系数确定脊柱和躯干畸形指标与脊柱侧弯研究协会-22评分之间的相关性，P < 0.01被认为具有显著性。
对于研究组，脊柱畸形（Cobb角）仅与脊柱侧弯研究协会-22功能（r = -0.39，P = 0.0022）领域显著相关。冠状面或横断面躯干畸形综合评分与任何脊柱侧弯研究协会-22评分均无相关性。横断面铃木驼背总和综合评分的驼背指数部分是唯一与功能（r = -0.45，P = 0.003）和自我形象（r = -0.36，P = 0.0040）显著相关的躯干测量指标。当单胸弯、King分类III和IV组合时，相关性最强：Cobb角与功能r = -0.53，P = 0.0027；Cobb角与自我形象r = -0.46，P = 0.0099；驼背指数与功能r = -0.60，P = 0.0005。对于双弯或胸腰弯模式组，脊柱畸形或任何躯干畸形测量指标与脊柱侧弯研究协会-22的回答之间均无显著相关性。
脊柱和上胸段横断面躯干畸形均显著影响特发性脊柱侧弯术前患者的功能和自我形象认知，但不影响疼痛或心理健康。然而，尽管有相当严格的证据标准，P ≤ 0.01，但显著的r值范围为-0.33至-0.68，这表明除了脊柱和躯干畸形外，还有其他因素影响特发性脊柱侧弯患者健康相关生活质量问卷的回答。未来有必要开展研究来确定这些因素。
