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青少年特发性脊柱侧凸患者畸形矫正对其精神状况的影响。

The effect of deformity correction on psychiatric condition of the adolescent with adolescent idiopathic scoliosis.

机构信息

Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.

Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.

出版信息

Eur Spine J. 2018 Sep;27(9):2233-2240. doi: 10.1007/s00586-018-5639-4. Epub 2018 May 25.

Abstract

PURPOSE

The purpose of this prospective study was to evaluate the effects of deformity correction on body image, quality of life, self-esteem, depression and anxiety in patients with adolescent idiopathic scoliosis (AIS) who underwent surgery.

METHODS

Between June 2014 and July 2015, 41 consecutive patients who underwent surgery for AIS were compared with the control group of 52 healthy patients regarding the changes in the pre- and postoperative quality of life and psychiatric status of patients with deformity correction. Body Cathexis Scale (BCS), Pediatric Quality of Life Inventory (PedsQL), Children's Depression Inventory (CDI), Piers-Harris self-esteem questionnaire (PH-SEQ) and state-trait Anxiety Inventory for Children were used to evaluate the patients.

RESULTS

There was a significant decrease in postoperative first-year Cobb angle and trunkal shift imbalance compared with the preoperative values (p = 0.0001 and p = 0.0001). Postoperative first-year thoracic kyphosis angle and body height showed a significant increase according to preoperative values (p = 0.0001 and p = 0.0001). Postoperative PH-SEQ score and PedsQL total score showed a significant increase in the study group compared to the preoperative level, but no significant difference was found between the control group. Postoperative CDI score, BCS score, STAI-state and STAI-trait scores decreased significantly in the study group compared with preoperative scores.

CONCLUSIONS

Surgical correction of deformity in AIS provided significant improvements regarding quality of life and psychiatric condition. Spinal surgeons should be aware of the possible psychological problems of AIS patients and should keep in mind that deformity correction not only improves physical health but also improves mental health. These slides can be retrieved under Electronic Supplementary Material.

摘要

目的

本前瞻性研究旨在评估脊柱畸形矫正对接受手术治疗的青少年特发性脊柱侧凸(AIS)患者的身体意象、生活质量、自尊、抑郁和焦虑的影响。

方法

2014 年 6 月至 2015 年 7 月,41 例 AIS 患者接受手术治疗,与对照组 52 例健康患者比较,评估患者术后畸形矫正前后生活质量和精神状态的变化。采用身体意象量表(BCS)、儿科生活质量量表(PedsQL)、儿童抑郁量表(CDI)、皮尔斯-哈里斯自尊问卷(PH-SEQ)和儿童状态-特质焦虑量表(STAI)对患者进行评估。

结果

与术前相比,术后第 1 年 Cobb 角和躯干偏移失衡显著降低(p=0.0001 和 p=0.0001)。术后第 1 年胸椎后凸角和身高较术前显著增加(p=0.0001 和 p=0.0001)。与术前相比,研究组术后 PH-SEQ 评分和 PedsQL 总分显著增加,但对照组无显著差异。与术前相比,研究组术后 CDI 评分、BCS 评分、STAI-状态和 STAI-特质评分显著降低。

结论

AIS 脊柱畸形矫正可显著改善生活质量和精神状态。脊柱外科医生应意识到 AIS 患者可能存在心理问题,并牢记畸形矫正不仅能改善身体健康,还能改善心理健康。这些幻灯片可在电子补充材料中检索。

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