Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.
Swedish Neuroscience Institute, Seattle, WA.
Spine (Phila Pa 1976). 2017 May 15;42(10):764-769. doi: 10.1097/BRS.0000000000001921.
This is a multicenter retrospective review of prospectively collected cases.
Our objective was to evaluate the relationship between patient satisfaction, health-related quality of life (HRQoL) scores, complications, and radiographic measures at 2 years postoperative follow-up.
For patients receiving operative management for adult spine deformity (ASD), the relationship between HRQoL measures, radiographic parameters, postoperative complications, and self-reported satisfaction remains unclear.
Data from 248 patients across 11 centers within the United States who underwent thoracolumbar fusion for ASD and had a minimum of 2 years follow-up was collected. Pre- and postoperative scores were obtained from the Scoliosis Research Society 22-item (SRS-22r), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and the Visual Analogue Scale. Sagittal vertical axis, coronal C7 plumbline, lumbar lordosis, pelvic tilt, T1 pelvic angle, and the difference between pelvic incidence and lumbar lordosis were assessed using postoperative radiographic films. Satisfaction (SAT) was assessed using the SRS-22r; patients were categorized as highly satisfied (HS) or less satisfied (LS). The correlation between SAT and HRQoL scores, radiographic parameters, and complications was determined.
When compared with LS (n = 60) patients, HS (n = 188) patients demonstrated greater improvement in final ODI, SF-36 component scores, SRS-Total, and Visual Analogue Scale back scores (P < 0.05). The correlations between SAT and the final follow-up and 2 year change from baseline values were moderate for Mental Component Summary, Physical Component Summary, and ODI or weak for HRQoL scores (P < 0.0001). The HS and LS groups were equal in pre- or final postoperative radiographic parameters. Occurrence of complications had no effect on satisfaction.
Among operatively treated ASD patients, satisfaction was moderately correlated with some HRQoL measures, and not with radiographic changes or postoperative complications. Other factors, such as patient expectations and relationship with the surgeon, may be stronger drivers of patient satisfaction.
这是一项前瞻性收集病例的多中心回顾性研究。
我们的目的是评估患者满意度、健康相关生活质量（HRQoL）评分、并发症以及术后 2 年随访时影像学测量之间的关系。
对于接受成人脊柱畸形（ASD）手术治疗的患者，HRQoL 测量、影像学参数、术后并发症和自我报告满意度之间的关系尚不清楚。
从美国 11 个中心的 248 例接受胸腰椎融合术治疗 ASD 并随访至少 2 年的患者中收集数据。术前和术后评分采用脊柱侧凸研究协会 22 项（SRS-22r）、Oswestry 功能障碍指数（ODI）、36 项简明健康状况调查问卷（SF-36）和视觉模拟评分（VAS）进行评估。术后影像学片评估矢状垂直轴、冠状 C7 铅垂线、腰椎前凸、骨盆倾斜、T1 骨盆角和骨盆入射角与腰椎前凸的差值。使用 SRS-22r 评估满意度（SAT），患者分为高度满意（HS）或不满意（LS）。确定 SAT 与 HRQoL 评分、影像学参数和并发症之间的相关性。
与 LS（n=60）患者相比，HS（n=188）患者的最终 ODI、SF-36 组成评分、SRS 总分和 VAS 背部评分均有显著改善（P<0.05）。SAT 与最终随访和基线值 2 年变化的相关性为精神成分综合评分、生理成分综合评分和 ODI 的中度相关，或为 HRQoL 评分的弱相关（P<0.0001）。HS 和 LS 组在术前或术后的影像学参数上是相等的。并发症的发生对满意度没有影响。
在接受手术治疗的 ASD 患者中，满意度与一些 HRQoL 测量指标中度相关，而与影像学改变或术后并发症无关。其他因素，如患者的期望和与外科医生的关系，可能是患者满意度的更强驱动力。
3 级
