Department of Orthopedic Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Korea.
Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-si, Korea.
Spine (Phila Pa 1976). 2019 Jul 15;44(14):996-1002. doi: 10.1097/BRS.0000000000002991.
A retrospective study.
To evaluate the psychological changes and employment outcomes following corrective osteotomy in patients with ankylosing spondylitis (AS).
To date, no study has investigated the changes in psychological status and subsequent improvement in employment outcome after correction of kyphotic deformities in patients with AS.
This study included 48 patients with AS who underwent corrective osteotomy for severe kyphotic deformity. Sagittal alignment was assessed radiographically. Clinical status was evaluated using the Short Form-36 Health Survey, psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS), and employment outcomes were assessed using the Lam Employment Absence and Productivity Scale (LEAPS). The degree of postoperative sagittal alignment correction was measured, and changes in clinical and employment outcomes and psychological status were evaluated. The relationship between the degree of sagittal alignment correction and each evaluation item was analyzed.
Following postoperative sagittal alignment correction, all patients could stand erect and look straight. Significant improvements were observed in the clinical and employment outcomes, as well as in patients' psychological status. The degree of sagittal vertical axis correction was significantly correlated with the HADS depression and the LEAPS total scores. The degree of correction of the chin-brow vertical angle was significantly correlated with the Short Form-36 mental health score, the HADS depression and anxiety scores, and the LEAPS total and productivity subscores. Notably, the improvement in the HADS depression score was significantly correlated with the LEAPS total score.
This study demonstrated the psychological changes and subsequent improvement in employment outcomes after corrective osteotomy in patients with AS. The degree of sagittal alignment correction was correlated with improvements in psychological status and employment outcomes.
回顾性研究。
评估强直性脊柱炎（AS）患者接受矫正性截骨术后的心理变化和就业结果。
迄今为止，尚无研究调查 AS 患者矫正后脊柱后凸畸形的心理状态变化和随后就业结果的改善。
本研究纳入 48 例因严重脊柱后凸畸形接受矫正性截骨术的 AS 患者。通过影像学评估矢状位排列。采用 36 项简短健康调查量表（SF-36）评估临床状况，采用医院焦虑抑郁量表（HADS）评估心理状态，采用 Lam 就业缺勤和生产力量表（LEAPS）评估就业结果。测量术后矢状位矫正程度，并评估临床和就业结果以及心理状态的变化。分析矢状位排列矫正程度与各评估项目之间的关系。
术后矢状位排列矫正后，所有患者均能直立和直视。临床和就业结果以及患者心理状态均显著改善。矢状垂直轴矫正程度与 HADS 抑郁和 LEAPS 总分显著相关。颏眉垂直角矫正程度与 SF-36 心理健康评分、HADS 抑郁和焦虑评分以及 LEAPS 总分和生产力子评分显著相关。值得注意的是，HADS 抑郁评分的改善与 LEAPS 总分显著相关。
本研究表明，AS 患者矫正性截骨术后存在心理变化，随后就业结果得到改善。矢状位排列矫正程度与心理状态和就业结果的改善相关。
4 级。
