Suk Kyung Soo, Baek Jin Hee, Park Jin-Oh, Kim Hak-Sun, Lee Hwan-Mo, Kwon Ji-Won, Moon Seong-Hwan, Lee Byung Ho
Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
Department of Orthopedic Surgery, International St Mary's Hospital, 291 Simgok-dong, Seo-Gu, Incheon 404-190, Republic of Korea.
Spine J. 2015 Mar 1;15(3):446-53. doi: 10.1016/j.spinee.2014.09.030. Epub 2014 Oct 7.
The functional level of children with progressive neuromuscular disease is a major factor that affects the quality of life (QOL) of parents. However, only a few publications have reported changes in the QOL of parents after correctional spinal surgery.
The purpose was to compare changes in QOL for both patients and parents after spinal correctional surgery for better sitting balance and to analyze correlation among radiographic parameters, functional outcome, and QOL questionnaires. Finally, the QOL of patients and parents was compared with the population norm.
This study is a retrospective analysis of prospectively gathered data.
From 2008 to 2011, 58 patients who underwent correctional surgery for progressive neuromuscular scoliosis and their parents were enrolled.
A Muscular Dystrophy Spine Questionnaire (MDSQ) and short-form questionnaire 36 (SF-36) were used.
The gathered functional outcome and QOL data using MDSQ and SF-36 for both enrolled patients and parents were compared preoperatively, postoperatively at 3 months, and at 1-year follow-up.
Mean age was 15.0±4.1 years. Forty male and 18 female patients were enrolled. Mean follow-up was 38.4±13.7 months. Cobb angle was 61.5°±23.5° preoperatively, 39.0°±20.1° immediately postoperative, and 40.0°±20.2° at the final follow-up. Cobb angle, pelvic obliquity, and lumbar lordosis were significantly improved after surgery (p<.001). Among sitting-related questions, answers to questions 15 (sitting comfortably), 16 (change weight in wheelchair), 22 (sit all day), 24 (sit at table for meal), 26 (keep balance while sitting in wheelchair), and 27 (look good while sitting in wheelchair) were significantly improved after correctional surgery (p<.001). Regarding the SF-36 scales for patients, bodily pain and social functioning significantly improved postoperatively (p<.001).
Muscular Dystrophy Spine Questionnaire results indicated that patients had significantly improved sitting balance-related outcomes, whereas the SF-36 indicated improvements only in bodily pain and social functioning scales. For parents, no SF-36 scales improved significantly postoperatively. Accordingly, improved sitting balance and QOL for neuromuscular scoliosis patients after surgery do not necessarily increase parent QOL.
进行性神经肌肉疾病患儿的功能水平是影响家长生活质量（QOL）的主要因素。然而，仅有少数出版物报道了脊柱矫正手术后家长生活质量的变化。
目的是比较脊柱矫正手术后患者和家长生活质量的变化，以获得更好的坐姿平衡，并分析影像学参数、功能结果和生活质量问卷之间的相关性。最后，将患者和家长的生活质量与总体标准进行比较。
本研究是对前瞻性收集的数据进行回顾性分析。
2008年至2011年，纳入了58例行进行性神经肌肉性脊柱侧弯矫正手术的患者及其家长。
使用肌肉萎缩脊柱问卷（MDSQ）和简短健康调查问卷36（SF - 36）。
使用MDSQ和SF - 36收集的已纳入患者及其家长的功能结果和生活质量数据，在术前、术后3个月和1年随访时进行比较。
平均年龄为15.0±4.1岁。纳入40例男性和18例女性患者。平均随访时间为38.4±13.7个月。术前Cobb角为61.5°±23.5°，术后即刻为39.0°±2O.1°，末次随访时为40.0°±20.2°。手术后Cobb角、骨盆倾斜度和腰椎前凸明显改善（p<0.001）。在与坐姿相关的问题中，问题15（舒适地坐着）、16（在轮椅上改变体重）、22（整天坐着）、24（坐在餐桌旁吃饭）、26（在轮椅上坐着时保持平衡）和27（坐在轮椅上时看起来不错）的答案在矫正手术后明显改善（p<0.001）。关于患者的SF - 36量表，术后身体疼痛和社会功能明显改善（p<0.001）。
肌肉萎缩脊柱问卷结果表明，患者与坐姿平衡相关的结果有显著改善，而SF - 36仅表明身体疼痛和社会功能量表有所改善。对于家长来说，术后SF - 36量表没有显著改善。因此，神经肌肉性脊柱侧弯患者术后坐姿平衡和生活质量的改善不一定会提高家长的生活质量。
