Theologis Alexander A, Crawford Matthew, Diab Mohammad
Department of Orthopaedic Surgery, University of California-San Francisco (UCSF), San Francisco, CA, USA.
Department of Orthopaedic Surgery, University of California-San Francisco (UCSF), San Francisco, CA, USA.
Spine Deform. 2018 Mar-Apr;6(2):148-155. doi: 10.1016/j.jspd.2017.07.003. Epub 2017 Oct 16.
Cohort analysis.
Document satisfaction with management and appearance concerns in children of different ethnicity who underwent spinal fusion/instrumentation for adolescent idiopathic scoliosis (AIS).
Scoliosis Research Society Questionnaire (SRS-30) outcomes in AIS indicate a link between appearance and satisfaction as well as ethnic variation in appearance domain. Exploration of these findings in the Scoliosis Appearance Questionnaire (SAQ) will allow better understanding of ethnic variation in appearance concerns.
Children with AIS who underwent posterior-only operations and completed the SAQ's question 31 were identified. Univariate logistic regression of SAQ questions 12-30 was used to assess relationships with ethnicity.
1,977 children [boys: 281, girls: 1,290, unspecified: 406; average age 15.1 ± 2.0 years preoperatively and 817 children (boys: 113, girls: 569, unspecified: 135; average age 15.1 ± 2.0 years) at 2 years' follow-up met inclusion criteria. The majority were Caucasian (57.3%). Few were Hispanic (3.4%). Preoperatively, the largest percentage of patients in each ethnic group answered "very true" to "wanting to be more even." Preoperatively, Asians were least likely to be concerned about evenness of shoulders, hips, waist, ribs, and chest in back (p < .05); however, they expressed greatest concern about height (p < .05). African Americans and Hispanics were more likely to be concerned about breast evenness and anterior chest and looking better in clothes (p < .05). African Americans were most concerned about overall evenness and evenness of shoulders, hips, waist, ribs, posterior chest, leg length, and looking more attractive (p < .05). Surgical scar was most important postoperatively for all ethnicities. African Americans and Hispanics were more self-conscious about scar (p < .05). African Americans were most likely to want to be more even and have more even shoulders, hips, waist, leg lengths, ribs, breasts, and chest postoperatively.
Ethnicity influenced appearance concerns in pre- and postoperative SAQ evaluation. Ethnic variation in appearance concerns should be taken into account and differentiated when counseling patients about AIS and surgical correction.
Level III.
队列分析。
记录接受青少年特发性脊柱侧凸（AIS）脊柱融合/内固定手术的不同种族儿童对治疗的满意度以及对外表的担忧。
AIS患者的脊柱侧凸研究学会问卷（SRS - 30）结果表明，外表与满意度之间存在关联，且在外貌领域存在种族差异。通过脊柱侧凸外貌问卷（SAQ）对这些发现进行探索，将有助于更好地理解外貌担忧方面的种族差异。
确定接受单纯后路手术并完成SAQ第31题的AIS患儿。使用SAQ第12 - 30题的单因素逻辑回归分析来评估与种族的关系。
1977名儿童[男孩：281名，女孩：1290名，未明确性别：406名；术前平均年龄15.1±2.0岁，817名儿童（男孩：113名，女孩：569名，未明确性别：135名；平均年龄15.1±2.0岁）在2年随访时符合纳入标准。大多数为白种人（57.3%）。少数为西班牙裔（3.4%）。术前，每个种族组中最大比例的患者对“希望更加匀称”回答“非常符合”。术前，亚洲人最不担心背部的肩部、臀部、腰部、肋骨和胸部的匀称性（p < 0.05）；然而，他们对身高最为关注（p < 0.05）。非裔美国人和西班牙裔更可能担心乳房匀称性、前胸以及穿衣服更好看（p < 0.05）。非裔美国人最关注整体匀称性以及肩部、臀部、腰部、肋骨、后胸部、腿长的匀称性，以及看起来更有吸引力（p < 0.05）。术后，手术疤痕对所有种族来说都是最重要的。非裔美国人和西班牙裔对疤痕更在意（p < 0.05）。非裔美国人最希望术后更加匀称，肩部、臀部、腰部、腿长、肋骨、乳房和胸部更加对称。
在术前和术后SAQ评估中，种族影响对外貌的担忧。在为AIS患者及手术矫正提供咨询时，应考虑并区分外貌担忧方面的种族差异。
三级。
