早发性脊柱侧凸患者手术治疗的健康相关生活质量：传统生长棒与磁控生长棒的 EOSQ 评分。
Health-Related Quality of Life in Early-Onset Scoliosis Patients Treated Surgically: EOSQ Scores in Traditional Growing Rod Versus Magnetically Controlled Growing Rods.
机构信息
New York Medical College, Valhalla, NY.
Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
出版信息
Spine (Phila Pa 1976). 2018 Jan 15;43(2):148-153. doi: 10.1097/BRS.0000000000002274.
STUDY DESIGN
Cross-sectional study.
OBJECTIVE
To compare quality of life and caregiver burden in traditional growing rod (TGR) and magnetic controlled growing rods (MCGR) patients.
SUMMARY OF BACKGROUND DATA
MCGR decrease surgical sessions associated with treatment of early onset scoliosis (EOS), hoping to minimize the burdens seen with repetitive invasive surgeries in TGR treatment. Although the clinical indications for these treatments have largely been agreed upon, there is a lack of understanding of their impact on patients' and families' quality of life.
METHODS
Inclusion criteria: ≤10 years of age at index procedure, major curve ≥30°, no previous spine surgery, minimum 1-year postoperative follow-up. The previously validated 24-item early onset scoliosis questionnaire (EOSQ-24) was utilized to assess quality of life. Statistic methods were applied to compare domain scores between TGR and MCGR patients.
RESULTS
Forty-four children with EOS were enrolled; 25 TGR and 19 MCGR. Groups were similar in sex and age at index surgery. Age at time of questionnaire and mean length of follow-up were significantly different; patients were older (14.0 vs. 8.8 yr) and had longer follow-up (101.3 vs. 34.3 mo) in TGR (P < 0.01). Deformity correction and complication rates were similar between groups. At the time of questionnaire, scores of economic burden and overall satisfaction in MCGR were significantly superior to those in TGR by univariate analysis. When controlled for duration of follow-up, some domain scores trended towards statistical significance, some remained stable, and others regressed to non-significance.
CONCLUSION
Health related quality of life data reveal superior outcomes in overall satisfaction and financial burden domains in the MCGR group. However, the positive effects of MCGR decrease when controlled for length of follow up, indicating that the MCGR is not yet a magic fix-all, and that the TGR remains an option in the treatment of EOS.
LEVEL OF EVIDENCE
研究设计
横断面研究。
目的
比较传统生长棒（TGR）和磁控生长棒（MCGR）患者的生活质量和照顾者负担。
背景资料概要
MCGR 减少了与早期发病脊柱侧凸（EOS）治疗相关的手术次数，希望最大限度地减少 TGR 治疗中重复侵入性手术带来的负担。尽管这些治疗的临床适应证已基本达成共识，但对它们对患者和家庭生活质量的影响缺乏了解。
方法
纳入标准：索引手术时年龄≤10 岁，主弯≥30°，无先前脊柱手术，术后至少 1 年随访。使用经过验证的 24 项早期发病脊柱侧凸问卷（EOSQ-24）评估生活质量。统计方法用于比较 TGR 和 MCGR 患者的各领域评分。
结果
共纳入 44 例 EOS 儿童；25 例 TGR 和 19 例 MCGR。两组在索引手术时的性别和年龄相似。在问卷调查时的年龄和平均随访时间存在显著差异；TGR 组患者年龄较大（14.0 岁比 8.8 岁），随访时间较长（101.3 个月比 34.3 个月）（P<0.01）。两组的畸形矫正和并发症发生率相似。在问卷调查时，MCGR 的经济负担和总体满意度评分在单因素分析中明显优于 TGR。当控制随访时间时，一些领域的评分趋于有统计学意义，一些保持稳定，而其他评分则回归无统计学意义。
结论
健康相关生活质量数据显示，MCGR 组在总体满意度和经济负担领域的结果更好。然而，当控制随访时间时，MCGR 的积极影响减弱，表明 MCGR 还不是一种神奇的万能疗法，TGR 仍然是治疗 EOS 的一种选择。
证据水平
3 级。
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