Marks Michelle, Petcharaporn Maty, Betz Randal R, Clements David, Lenke Larry, Newton Peter O
Department of Pediatric Orthopedics, Rady Children's Hospital & Health Center, San Diego, CA, USA.
Spine (Phila Pa 1976). 2007 Mar 1;32(5):544-9. doi: 10.1097/01.brs.0000256908.51822.6e.
This research was part of a multicenter study of the surgical treatment of adolescent idiopathic scoliosis (AIS).
To compare the radiographic and perioperative surgical treatment outcomes of male AIS patients with female AIS patients.
The results of treatment in male patients with idiopathic scoliosis have not been widely reported. Only 1 study has evaluated the differences in operative treatment outcomes between male and female patients with AIS.
Data were collected for patients who met the indications for surgical intervention at 8 separate institutions. Radiographic, perioperative, and pulmonary function variables for male and female AIS patients treated surgically were analyzed. A univariate analysis of variance with the alpha level adjusted to P < or = 0.01 was used.
The data for 547 (449 females and 98 males) patients were included in this analysis. Posterior instrumentation (vs. anterior instrumentation) was performed slightly more often in males than females (51% vs. 44%, respectively). The preoperative primary curve magnitude was similar for both genders, but flexibility was less in males (44% vs. 49%; P = 0.01). Postoperative percent correction and the ratio of percent correction to preoperative flexibility were both similar in males versus females. Analysis of the perioperative variables yielded that estimated blood loss was higher in males than females (1342 vs. 898 cc, respectively; P = 0.001). Males reported greater pain on postoperative day 1 (6.1 vs. 5.4; P = 0.01), however, conversion to oral pain medication was similar for both. Preoperative and postoperative pulmonary function was similar for both genders.
Male AIS patients had slightly more rigid primary curves compared to females but a similar degree of postoperative scoliosis correction. Differences in the preoperative status and perioperative course did not compromise the outcomes of surgical treatment as in all other measures; the results were comparable between the genders.
本研究是青少年特发性脊柱侧凸(AIS)手术治疗多中心研究的一部分。
比较男性AIS患者与女性AIS患者的影像学及围手术期手术治疗结果。
特发性脊柱侧凸男性患者的治疗结果尚未得到广泛报道。仅有1项研究评估了男性和女性AIS患者手术治疗结果的差异。
收集8个不同机构中符合手术干预指征患者的数据。对接受手术治疗的男性和女性AIS患者的影像学、围手术期及肺功能变量进行分析。采用α水平调整为P≤0.01的单因素方差分析。
本分析纳入了547例患者的数据(449例女性和98例男性)。男性患者行后路内固定(相对于前路内固定)的比例略高于女性(分别为51%和44%)。术前主弯角度在两性中相似,但男性的柔韧性较差(分别为44%和49%;P = 0.01)。术后矫正百分比以及矫正百分比与术前柔韧性的比值在男性和女性中相似。围手术期变量分析显示,男性的估计失血量高于女性(分别为1342 cc和898 cc;P = 0.001)。男性在术后第1天报告的疼痛更严重(6.1对5.4;P = 0.01),然而,两者转换为口服止痛药物的情况相似。术前和术后肺功能在两性中相似。
与女性相比,男性AIS患者的主弯稍僵硬,但术后脊柱侧凸矫正程度相似。术前状况和围手术期过程的差异并未像所有其他指标那样影响手术治疗结果;两性结果具有可比性。