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哥本哈根病非手术或手术治疗患者的临床表现及结局:30年经验

Presentation and outcome of patients treated non-operatively or operatively for Copenhagen Disease: a 30-year experience.

作者信息

Malagelada Francesc, Butler Joseph S, Rajput Lylah, Iliadis Alexios, Mansouri Reza, Saifuddin Asif, Gibson Alexander

机构信息

Spinal Deformity Unit, Department of Spinal Surgery, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK.

The Institute of Orthopaedic and Musculoskeletal Science, Department of Radiology, The Royal National Orthopaedic Hospital, Stanmore, UK.

出版信息

Eur Spine J. 2016 Mar;25(3):919-27. doi: 10.1007/s00586-015-4324-0. Epub 2015 Nov 18.

Abstract

PURPOSE

Our purpose was to analyse the presentation, management and clinical outcome of patients treated operatively and non-operatively for Copenhagen Disease (CD).

METHODS

We performed a retrospective analysis of 10 patients (n = 10) with CD, with a mean follow-up time of 14.7 years. Seven patients underwent non-operative treatment and three patients were treated operatively. Clinical presentation and radiological findings were analysed. Health-related quality of life (HRQOL) outcome measures utilized included Oswestry Disability Index (ODI), Short Form 12 Health Survey (SF-12) and visual analogue scale (VAS).

RESULTS

Patients tended to present with back pain. No significant difference was detected in functional scores at time of diagnosis and when compared to last follow-up. ODI improved from 20.0 to 18.4 (p = 0.839), PCS component of SF-12 from 44.5 to 45.9 (p = 0.719), MCS component of SF-12 from 45.7 to 46.9 (p = 0.840) and VAS score remained at 2.8 (p = 1.000). There was no significant difference in functional scores when comparing operative and non-operative treatment groups.

CONCLUSION

CD is likely to remain stable with time or slightly improve after treatment according to functional outcomes tests. Progression of the kyphosis can be halted at different degrees with operative and non-operative treatments although it does not correlate with changes in symptomatology.

摘要

目的

我们的目的是分析接受手术和非手术治疗的哥本哈根病(CD)患者的临床表现、治疗方法及临床结局。

方法

我们对10例CD患者进行了回顾性分析,平均随访时间为14.7年。7例患者接受了非手术治疗,3例患者接受了手术治疗。分析了临床表现和影像学检查结果。所采用的与健康相关的生活质量(HRQOL)结局指标包括奥斯威斯利残疾指数(ODI)、简明健康调查12项量表(SF-12)和视觉模拟量表(VAS)。

结果

患者多表现为背痛。诊断时与最后一次随访时的功能评分无显著差异。ODI从20.0改善至18.4(p = 0.839),SF-12的生理健康分量表(PCS)从44.5改善至45.9(p = 0.719),SF-12的心理健康分量表(MCS)从45.7改善至46.9(p = 0.840),VAS评分保持在2.8(p = 1.000)。手术治疗组与非手术治疗组的功能评分无显著差异。

结论

根据功能结局测试,CD可能随时间保持稳定或治疗后略有改善。手术和非手术治疗可在不同程度上阻止后凸畸形的进展,尽管这与症状变化无关。

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