Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Spine (Phila Pa 1976). 2017 Nov 1;42(21):E1245-E1250. doi: 10.1097/BRS.0000000000002147.
Prospective cross-sectional study.
To evaluate patients' and parents' concerns so they can be addressed with appropriate preoperative counseling.
Despite much research on outcomes for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS), little is available about preoperative fears or concerns.
Patients with AIS undergoing PSF, their parents, and surgeons were prospectively enrolled and asked to complete a survey on their fears and concerns about surgery at their preoperative appointment.
Forty-eight patients and parents completed surveys. Four attending pediatric spine surgeons participated and submitted 48 responses. Mean age of patients was 14.2 years. On a scale of 0 to 10, mean level of concern reported by parents (6.9) was higher than that reported by patients (4.6). Surgeons rated the procedure's complexity on a scale of 0 to 10 and reported a mean of 5.2. Neither patients' nor parents' level of concern correlated with the surgeons' assessment of the procedure's complexity level (R = 0.19 and 0.12, P = 0.20 and P = 0.42, respectively). Top three concerns for patients were pain (25%), ability to return to activities (21%), and neurologic injury (17%). Top three concerns for parents were pain (35%), neurologic injury (21%), and amount of correction (17%). Top three concerns for surgeons were postoperative shoulder balance (44%), neurologic injury (27%), and lowest instrumented vertebrae selection (27%). Patients reported the same concerns 23% of the time as parents, and 17% of the time as surgeons. Parents and surgeons reported the same concerns 21% of the time.
Pain was the greatest concern for both patients and parents but was rarely listed as a concern by surgeons. Parent and patient level of concern did not correlate to the surgeon's assessment of the procedure's complexity. Neurologic injury was a top concern for all groups, but otherwise there was little overlap between physician, patient, and parent concerns.
前瞻性横断面研究。
评估患者和家长的关注点，以便通过适当的术前咨询来解决这些问题。
尽管对青少年特发性脊柱侧凸（AIS）后路脊柱融合术（PSF）的结果进行了大量研究，但关于术前恐惧或担忧的信息却很少。
前瞻性纳入接受 PSF 的 AIS 患者、他们的父母和外科医生，并要求他们在术前预约时填写一份关于他们对手术的恐惧和担忧的调查问卷。
48 名患者及其父母完成了调查。4 名主治儿科脊柱外科医生参与并提交了 48 份回复。患者的平均年龄为 14.2 岁。父母报告的平均担忧程度（6.9）高于患者（4.6）。外科医生对手术的复杂性进行了 0 到 10 的评分，报告的平均得分为 5.2。患者和家长的担忧程度均与外科医生对手术复杂程度的评估无关（R = 0.19 和 0.12，P = 0.20 和 P = 0.42）。患者的前三大担忧是疼痛（25%）、恢复活动能力（21%）和神经损伤（17%）。家长的前三大担忧是疼痛（35%）、神经损伤（21%）和矫正量（17%）。外科医生的前三大担忧是术后肩部平衡（44%）、神经损伤（27%）和最低固定椎骨选择（27%）。患者与家长的担忧相同的情况占 23%，与外科医生的担忧相同的情况占 17%。家长和外科医生的担忧相同的情况占 21%。
疼痛是患者和家长最关心的问题，但很少被外科医生列为关注点。家长和患者的担忧程度与外科医生对手术复杂程度的评估无关。神经损伤是所有群体的首要关注点，但医生、患者和家长的关注点之间几乎没有重叠。
3 级。
