Korovessis Panagiotis, Zacharatos Spyridon, Koureas Georgios, Megas Panagiotis
Orthopaedic Department, General Hospital Agios Andreas, 26224, Patras, Greece.
Eur Spine J. 2007 Apr;16(4):537-46. doi: 10.1007/s00586-006-0214-9. Epub 2006 Sep 5.
Bracing is the most effective non-operative treatment for mild progressive spinal deformities in adolescence but it has shown a considerable impact on several aspects of adolescents' functioning. This cross-sectional study investigated the self-perceived health status of adolescents with the two most common deformities, treated with body orthosis. Seventy-nine adolescents with spinal deformities (idiopathic adolescent scoliosis, thoracic Scheuermann kyphosis) and 62 adolescents without spinal deformities were asked to complete the Quality of Life profile for Spine Deformities Instrument. This study showed that adolescents with deformities are significantly less likely to have back pain in training than controls, but more likely to have difficulty in forward bending, and in the most common daily activities while in brace. These individuals claim they wake up because of back pain and feel quite nervous with the external appearance of their body. These patients face often problems with their relations with friends, while they reported difficulties in getting up from bed and sleep at night more often than their counterparts without deformities. As they grow older, patients feel increasing ashamed of their body, as they are more concerned about the future effect of the deformity on their body. As the bracing time increases, patients have much more probability than controls to get low back pain. Girls with deformity have a higher probability than boys to get low back pain while working in the house and while training. Individuals with larger spinal curvatures have more difficulties in bending and increased incidence of back pain than their counterparts with smaller curvatures. Psychological reasons associated mainly with relations at school and back pain are the main causes for low compliance in adolescents with spinal deformities treated with body orthosis. Careful instructions for all individuals who will undergo brace therapy, psychological support for all patients who develop psychological reactions and physical training particularly for older girls should be recommended to increase bracing compliance.
支具治疗是青少年轻度进行性脊柱畸形最有效的非手术治疗方法，但它已显示出对青少年功能的多个方面有相当大的影响。这项横断面研究调查了接受身体矫形器治疗的患有两种最常见畸形的青少年的自我感知健康状况。79名患有脊柱畸形（特发性青少年脊柱侧凸、胸椎Scheuermann驼背）的青少年和62名没有脊柱畸形的青少年被要求完成脊柱畸形生活质量概况量表。这项研究表明，与对照组相比，患有畸形的青少年在训练时背痛的可能性显著降低，但在佩戴支具时向前弯曲以及进行最常见的日常活动时更有可能出现困难。这些个体声称他们会因背痛醒来，并且对自己身体的外观感到非常紧张。这些患者在与朋友的关系方面经常面临问题，同时他们报告说，与没有畸形的同龄人相比，他们更经常在起床和夜间睡眠方面存在困难。随着年龄的增长，患者对自己的身体越来越感到羞愧，因为他们更担心畸形对身体的未来影响。随着支具佩戴时间的增加，患者比对照组更有可能出现下背痛。患有畸形的女孩在做家务和训练时比男孩更有可能出现下背痛。脊柱弯曲度较大的个体在弯曲方面比弯曲度较小的同龄人有更多困难，背痛发生率也更高。主要与学校人际关系和背痛相关的心理原因是接受身体矫形器治疗的脊柱畸形青少年依从性低的主要原因。对于所有将接受支具治疗的个体应给予仔细指导，对出现心理反应的所有患者给予心理支持，尤其应建议对年龄较大的女孩进行体育锻炼，以提高支具治疗的依从性。
