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1463例特发性脊柱侧凸患者的家族史及其与侧弯大小和治疗的关系

Family history and its association to curve size and treatment in 1,463 patients with idiopathic scoliosis.

作者信息

Grauers Anna, Danielsson Aina, Karlsson Magnus, Ohlin Acke, Gerdhem Paul

机构信息

Department of Orthopaedics, Sundsvall and Härnösand County Hospital, Sundsvall, Sweden,

出版信息

Eur Spine J. 2013 Nov;22(11):2421-6. doi: 10.1007/s00586-013-2860-z. Epub 2013 Jun 26.

Abstract

PURPOSE

To study family history in relation to curve severity, gender, age at diagnosis and treatment in idiopathic scoliosis.

METHODS

A self-assessment questionnaire on family history of scoliosis was administered to 1,463 untreated, brace or surgically treated idiopathic scoliosis patients.

RESULTS

Out of the 1,463 patients, 51 % had one or more relatives with scoliosis. There was no significant difference between females and males, nor between juvenile and adolescent study participants in this respect (p = 0.939 and 0.110, respectively). There was a significant difference in maximum curve size between patients with one or more relatives with scoliosis (median 35°, interquartile range 25) and patients without any relative with scoliosis (median 32°, interquartile range 23) (p = 0.022). When stratifying patients according to treatment (observation, brace treatment or surgery), we found that it was more common to have a relative with scoliosis among the treated patients (p = 0.011). The OR for being treated was 1.32 (95% CI 1.06-1.64) when the patient had a relative with scoliosis, compared to not having.

CONCLUSIONS

Larger curve sizes were found in patients with a family history of scoliosis than in the ones without. No relation between family history and gender or between family history and age at onset of idiopathic scoliosis was found. Although the presence of a family history of scoliosis may not be a strong prognostic risk factor, it indicates that these patients are at higher risk of developing a more severe curve.

摘要

目的

研究特发性脊柱侧凸的家族史与曲线严重程度、性别、诊断年龄及治疗的关系。

方法

对1463例未经治疗、采用支具治疗或手术治疗的特发性脊柱侧凸患者进行了关于脊柱侧凸家族史的自我评估问卷调查。

结果

在1463例患者中,51%有一名或多名患有脊柱侧凸的亲属。在这方面,女性和男性之间、青少年和青年研究参与者之间均无显著差异(p值分别为0.939和0.110)。有一名或多名患有脊柱侧凸亲属的患者与没有脊柱侧凸亲属的患者相比,最大曲线大小存在显著差异(中位数35°,四分位间距25)(中位数32°,四分位间距23)(p = 0.022)。根据治疗方式(观察、支具治疗或手术)对患者进行分层时,我们发现接受治疗的患者中有脊柱侧凸亲属的情况更为常见(p = 0.011)。与没有脊柱侧凸亲属的患者相比,有脊柱侧凸亲属的患者接受治疗的比值比为1.32(95%置信区间1.06 - 1.64)。

结论

有脊柱侧凸家族史的患者比没有家族史的患者曲线更大。未发现家族史与性别之间或家族史与特发性脊柱侧凸发病年龄之间存在关联。虽然脊柱侧凸家族史的存在可能不是一个强大的预后风险因素,但它表明这些患者发生更严重曲线的风险更高。

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