Park Ye-Soo, Kim Hong-Sik, Baek Seung-Wook
Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Gyungchoon-ro 153, Guri city, Gyunggi-do, Korea.
Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Gyungchoon-ro 153, Guri city, Gyunggi-do, Korea.
Spine J. 2014 Sep 1;14(9):1921-7. doi: 10.1016/j.spinee.2013.11.013. Epub 2013 Nov 16.
Little is known about the psychological status in patients with ankylosing spondylitis (AS) before and after correction of fixed sagittal imbalance.
The aim of this study was to evaluate the changes in patients' psychological status after surgical correction and the existence of a correlation between psychological state and the angle of correction.
A retrospective study was performed to assess radiological and clinical results, and psychological status in patients with AS with fixed kyphotic deformity.
The sample comprises 24 patients with AS with fixed sagittal imbalance who underwent one-stage corrective osteotomies at our hospital between March 2006 and May 2010. All of the patients included in this study demonstrated an inability to look straight forward because of severe kyphotic deformities.
The radiologic analysis included evaluation of thoracic kyphosis, lumbar lordosis, and the sagittal vertical axis (SVA) of the spine. Clinical assessments were performed with Short Form 36 (SF-36), the Bath Ankylosing Spondylitis Function Index (BASFI), and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Patient psychological status was assessed using the Hospital Anxiety and Depression Questionnaire (HADS) and the Health Locus of Control-Form C Questionnaire (HLC-C).
Each of the above measurements was recorded before and 1 year after the surgery. The changes derived from each measurement before and after the surgery were evaluated. We also analyze the correlations among the radiological, clinical, psychological, and mental evaluations.
Mean thoracic kyphosis changed from 38.5° to 33.3°. Mean lumbar lordosis was corrected from 13.8° to 26.1°, and the SVA was improved from 110.8 mm to 49.7 mm. There was significant improvement in the SF-36, BASDAI, BASFI, HADS, and HLC-C scores. The SVA changes were closely linked to BASFI and psychological status, especially anxiety and depression.
The scores of disease status, general health, and psychological status were improved significantly after correction of kyphotic deformity. And the correction of sagittal imbalance was correlated significantly with anxiety and depression.
对于强直性脊柱炎（AS）患者在固定矢状面失衡矫正前后的心理状态了解甚少。
本研究旨在评估手术矫正后患者心理状态的变化，以及心理状态与矫正角度之间是否存在相关性。
进行一项回顾性研究，以评估强直性脊柱炎伴固定后凸畸形患者的影像学和临床结果以及心理状态。
样本包括24例患有固定矢状面失衡的强直性脊柱炎患者，他们于2006年3月至2010年5月在我院接受了一期矫正截骨术。本研究纳入的所有患者均因严重后凸畸形而无法直视前方。
影像学分析包括评估胸椎后凸、腰椎前凸和脊柱矢状垂直轴（SVA）。使用简短健康调查问卷（SF-36）、巴斯强直性脊柱炎功能指数（BASFI）和巴斯强直性脊柱炎疾病活动指数（BASDAI）进行临床评估。使用医院焦虑抑郁量表（HADS）和健康控制源C型问卷（HLC-C）评估患者的心理状态。
上述各项测量在手术前和手术后1年进行记录。评估手术前后各项测量的变化。我们还分析了影像学、临床、心理和精神评估之间的相关性。
平均胸椎后凸从38.5°变为33.3°。平均腰椎前凸从13.8°矫正至26.1°，SVA从110.8 mm改善至49.7 mm。SF-36、BASDAI、BASFI、HADS和HLC-C评分有显著改善。SVA的变化与BASFI和心理状态密切相关，尤其是焦虑和抑郁。
后凸畸形矫正后，疾病状态、总体健康和心理状态评分显著改善。矢状面失衡的矫正与焦虑和抑郁显著相关。
