Sánchez-Mariscal Felisa, Gomez-Rice Alejandro, Rodríguez-López Tamara, Zúñiga Lorenzo, Pizones Javier, Núñez-García Ana, Izquierdo Enrique
Spinal Unit, Hospital Universitario de Getafe, Carretera de Toledo km 12.5, Getafe, Madrid 28905, Spain.
Spinal Unit, Hospital Universitario de Getafe, Carretera de Toledo km 12.5, Getafe, Madrid 28905, Spain.
Spine J. 2017 Jan;17(1):56-61. doi: 10.1016/j.spinee.2016.08.007. Epub 2016 Aug 5.
Most of the papers correlate sagittal radiographic parameters with health-related quality of life (HRQOL) scores for patients with scoliosis. However, we do not know how changes in sagittal profile influence clinical outcomes after surgery in adult population operated for mainly frontal deformity.
This study aimed to analyze spinal sagittal profile in a population operated on adult idiopathic scoliosis (AS) and to describe variations in sagittal parameters after surgery and the association between those variations and clinical outcomes.
DESIGN/SETTING: This is a historical cohort study.
We included in this study 40 patients operated on AS, older than 40 at the time of surgery (mean age 54.9), and with more than 2-year follow-up (mean 7.4 years).
Full-length free-standing radiographs, Scoliosis Research Society 22 (SRS22) and Short Form 36 (SF36) instruments, and satisfaction with outcomes were available at final follow-up.
Sagittal preoperative and final follow-up radiographic parameters, radiographic correlation with HRQOL scores at final follow-up, and association between satisfaction and changes in sagittal profile were analyzed. A multivariate analysis was performed. No funds were received for this article.
Preoperatively, the spinal sagittal plane tended to exhibit kyphosis. Most sagittal parameters did not improve at final follow-up with respect to preoperative values. We saw, after univariate analysis, that worse sagittal profile leads to worse HRQOL, but after multivariate analysis, only spinal tilt (ST) persisted as possible predictor for worse SRS activity scores. Frontal Cobb significantly improved. Most patients (82%) were satisfied with final outcomes. Variations in sagittal profile parameters did not differ between satisfied and dissatisfied patients.
Although most sagittal plane parameters did not improve after surgery, surgical treatment in AS achieves a high satisfaction rate. Good clinical results do not correlate with improving sagittal plane parameters. Sagittal profile measurements are not helpful to decide surgical treatment in patients with mainly frontal deformity.
大多数论文将脊柱侧凸患者的矢状面影像学参数与健康相关生活质量（HRQOL）评分相关联。然而，我们并不清楚矢状面形态的变化如何影响主要因额状面畸形而接受手术的成年患者术后的临床结果。
本研究旨在分析接受成人特发性脊柱侧凸（AS）手术患者的脊柱矢状面形态，并描述术后矢状面参数的变化以及这些变化与临床结果之间的关联。
设计/地点：这是一项历史性队列研究。
本研究纳入了40例接受AS手术的患者，手术时年龄超过40岁（平均年龄54.9岁），且随访时间超过2年（平均7.4年）。
在末次随访时可获得全长站立位X线片、脊柱侧凸研究学会22项（SRS22）和简明健康状况调查36项（SF36）量表，以及对结局的满意度。
分析术前和末次随访时的矢状面影像学参数、末次随访时影像学参数与HRQOL评分的相关性，以及满意度与矢状面形态变化之间的关联。进行了多变量分析。本文未获得任何资金支持。
术前，脊柱矢状面倾向于表现为后凸。与术前值相比，大多数矢状面参数在末次随访时并未改善。单变量分析后，我们发现矢状面形态越差，HRQOL越差，但多变量分析后，只有脊柱倾斜度（ST）持续作为SRS活动评分较差的可能预测因素。额状面Cobb角显著改善。大多数患者（82%）对最终结局满意。满意和不满意患者之间矢状面形态参数的变化无差异。
虽然术后大多数矢状面参数并未改善，但AS的手术治疗满意度较高。良好的临床结果与矢状面参数的改善无关。矢状面形态测量对主要为额状面畸形的患者决定手术治疗并无帮助。
