Duri Rudo, Brown Kaitlyn, Johnson Megan, McIntosh Amy
Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75930, USA.
Spine Deform. 2019 Jan;7(1):80-83. doi: 10.1016/j.jspd.2018.06.011.
Adolescent idiopathic scoliosis (AIS) patients undergoing spine fusion (SF) had their data prospectively collected. The SRS Spine Appearance Questionnaire (SAQ) was the primary outcome measure. The data were reviewed in a retrospective manner.
Patient concerns about breast/chest wall asymmetry in AIS is high. This study sought to determine the improvement after spinal fusion (SF).
Breast/chest wall asymmetry is a significant physical deformity associated with AIS. No literature exists on patient satisfaction related to improved breast/chest wall appearance after SF surgery.
474 patients undergoing SF for AIS from 2006 to 2014 completed the SRS SAQ preoperation and at two years postoperation. Data were prospectively collected and reviewed in a retrospective manner. The SAQ includes two statements regarding breast/chest wall asymmetry (19 and 20). Statistical analysis was performed to determine a relationship between improved SAQ responses and any clinical/radiographic or surgical parameters.
395 females and 79 males (14.4 ± 2.0 years) with preoperation and two-year postoperation Cobb angle 60.6 ± 11.5 and 26.6 ± 12.1 were reviewed. Before surgery, 68.0% of patients identified with the statement "I want to have more even breasts" compared with 37.0% at two years postoperation. In addition, 78.9% identified with the statement "I want to have a more even chest in the front" preoperatively compared with 34.0% at two years postoperation. Positive preoperative responses correlated with scoliometer (p = .029) (p = .044) and Cobb angle of the major curve (p = .048 and p = .006). At two years postoperation, there was a significant number of patients (76%) who had at least a two-point decrease in their response to either statement (p < .0001).
Breast asymmetry is a significant concern of many AIS patients, including males, and correlates with preoperative curve magnitude. SF results in significant improvement in patient perception of breast/chest wall asymmetry, with 76% of patients reporting good outcomes at two years postoperation.
Level 2.
对接受脊柱融合术（SF）的青少年特发性脊柱侧凸（AIS）患者的数据进行前瞻性收集。SRS脊柱外观问卷（SAQ）是主要的结局指标。对数据进行回顾性分析。
AIS患者对乳房/胸壁不对称问题的关注度较高。本研究旨在确定脊柱融合术（SF）后的改善情况。
乳房/胸壁不对称是与AIS相关的一种显著身体畸形。目前尚无关于SF手术后乳房/胸壁外观改善与患者满意度相关的文献。
2006年至2014年期间，474例接受AIS脊柱融合术的患者在术前及术后两年完成了SRS SAQ。数据进行前瞻性收集并回顾性分析。SAQ包括两条关于乳房/胸壁不对称的陈述（陈述19和陈述20）。进行统计分析以确定SAQ回答的改善与任何临床/影像学或手术参数之间的关系。
对395名女性和79名男性（年龄14.4±2.0岁）进行了回顾，术前和术后两年的Cobb角分别为60.6±11.5和26.6±12.1。术前，68.0%的患者认同“我希望两侧乳房更匀称”这一陈述，而术后两年这一比例为37.0%。此外，术前78.9%的患者认同“我希望胸部前方更匀称”这一陈述，术后两年这一比例为34.0%。术前的肯定回答与脊柱侧凸测量仪（p = .029）（p = .044）以及主弯的Cobb角（p = .048和p = .006）相关。术后两年，有相当数量的患者（76%）对任一陈述的回答至少降低了两分（p < .0001）。
乳房不对称是许多AIS患者（包括男性）的一个重大关注点，且与术前侧弯程度相关。脊柱融合术使患者对乳房/胸壁不对称的认知有显著改善，76%的患者在术后两年报告效果良好。
2级。
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