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41 例青少年特发性脊柱侧凸患者支具治疗联合脊柱特定物理治疗后 5 年的社会经济和生活质量结局的观察性回顾性研究。

Observational retrospective study on socio-economic and quality of life outcomes in 41 patients with adolescent idiopathic scoliosis 5 years after bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE).

机构信息

Department of Orthopedic Surgery and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.

Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.

出版信息

Eur Spine J. 2019 Mar;28(3):611-618. doi: 10.1007/s00586-018-5746-2. Epub 2018 Aug 25.

Abstract

PURPOSE

We analysed socio-economic- and health-related quality of life (primary outcome) and radiological outcome (secondary outcome) 5 years after full time rigid bracing (FTRB) plus physiotherapeutic scoliosis-specific exercises (PSSE) in adolescent idiopathic scoliosis.

METHODS

We included 41 patients (38 female and 3 male) treated with FTRB (Chênau brace) and PSSE (Schroth) between 2001 and 2010. The study protocol included a clinical and radiological examination, the completion of the SRS-24 questionnaire and acquisition of data on socio-economic factors (educational and employment status) and physical activity. Descriptive statistics were used to analyse the data; differences between patients with mild (< 30°) and severe curves (30°-50°) regarding hrQoL outcomes were analysed using the Mann-Whitney U Test.

RESULTS

Primary outcomes showed full employment (higher education, 39%, and full-time work, 61%) and the majority of the patients (79.9%) performing moderate sports two to four times per week. The SRS-24 questionnaire produced a total mean score (MS) of 4.0 (79.9%). Patients with mild curves had a significantly better total score (MS 4.1 vs. MS 3.8, p = 0.020) and were more satisfied with the treatment (MS 4.3 vs MS 3.9, p = 0.020). As to the secondary outcomes, from start of bracing to follow-up (a mean of 6.7 years after brace weaning), the average Cobb angle changed from 28.6° to 25.6° (range 4°-48°); in 51.2% the curve angles could be maintained after weaning.

CONCLUSIONS

Compared with the literature, our results showed similar curve development and hrQoL (pain, self-image and function) and better results regarding satisfaction with treatment. In comparison with the average population, there were no disadvantages as to occupation, education and sports. These slides can be retrieved under Electronic Supplementary Material.

摘要

目的

我们分析了青少年特发性脊柱侧凸患者在接受全时刚性支具(FTRB)加物理治疗特发性脊柱侧凸特定运动(PSSE)治疗 5 年后的社会经济和健康相关生活质量(主要结果)和影像学结果(次要结果)。

方法

我们纳入了 41 名(38 名女性,3 名男性)于 2001 年至 2010 年期间接受 FTRB(Chenau 支具)和 PSSE(Schroth)治疗的患者。研究方案包括临床和影像学检查、SRS-24 问卷的完成以及社会经济因素(教育和就业状况)和身体活动数据的采集。使用描述性统计分析数据;使用 Mann-Whitney U 检验分析轻度(<30°)和重度(30°-50°)曲线患者之间的生活质量结果差异。

结果

主要结果显示,大多数患者(79.9%)从事全职工作(高等教育,39%;全职工作,61%),并且大多数患者(79.9%)每周进行两到四次中等强度的运动。SRS-24 问卷产生的总平均得分(MS)为 4.0(79.9%)。轻度曲线患者的总分(MS 4.1 与 MS 3.8,p=0.020)和治疗满意度(MS 4.3 与 MS 3.9,p=0.020)显著更好。就次要结果而言,从支具开始到随访(支具去除后平均 6.7 年),平均 Cobb 角从 28.6°变为 25.6°(范围 4°-48°);在 51.2%的患者中,曲线角度在支具去除后可以得到维持。

结论

与文献相比,我们的结果显示出类似的曲线发展和生活质量(疼痛、自我形象和功能),并且对治疗满意度的结果更好。与普通人群相比,在职业、教育和运动方面没有劣势。这些幻灯片可以在电子补充材料中检索到。

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