Orton Orthopaedic Hospital and Research Institute, Tenholantie 10, 00280, Helsinki, Finland.
Eur Spine J. 2019 Dec;28(12):3053-3065. doi: 10.1007/s00586-019-06089-9. Epub 2019 Aug 2.
Scoliosis with spondylolisthesis was described in 4.4-48%. No information on clinical impact or outcome is available.
To determine the prevalence of this pathology and to investigate its affect on the course of adolescent idiopathic scoliosis (AIS).
A retrospective comparative study using patients' records, radiographs, the national inpatient registry, and Patient-rated outcome measures (PROM): Oswestry disability index (ODI), modif.SRS-24 questionnaire, WHO-Quality of life index (WHOQoL), Numerical rating scale (NRS) for pain. Clinical follow-up time was 4.4 (4.3) years, and follow-up rate was 95%. PROM follow-up time 26.4 (2.8) years χ statistics and t-tests were applied. Significance threshold was set at P < 0.05.
Out of 1531 consecutive Caucasian AIS patients, aged 13.9 (1.8) years, primary curve 29.2 (11.5) drs., 120 (7.8%) had low-grade isthmic L5-slip of mean 15.0 (8.3)% (Study group = S). The distribution of the curve types in the study group was comparable to the remaining 1411 patients with AIS only. In comparison with a pair-matched control group (C) at admission, back pain interfering with activities of daily living had 4.2% of the study group and 1.7% of the control group, at clinical follow-up 2.6/4.2% resp. (n.s.). Between groups S/C, there was no significant difference concerning scoliosis treatment: observation 38.3/45.8%, bracing 48.3/46.6%, surgery 10.8/10.2%. Results of treatment were equal in both groups. Long-term outcomes (ODI, SRS-24, WHOQoL, NRS-back/leg pain) were comparable.
The prevalence of low-grade isthmic L5-spondylolisthesis in AIS patients was 7.8%. The presence of low-grade isthmic spondylolisthesis did not influence the curve type of AIS nor did it affect the course or long-term outcome. These slides can be retrieved under Electronic Supplementary Material.
脊柱侧凸伴脊柱滑脱的发生率为 4.4-48%。目前尚无关于其临床影响或结果的信息。
确定该病理学的发生率，并研究其对青少年特发性脊柱侧凸（AIS）病程的影响。
使用患者病历、影像学资料、全国住院登记处和患者报告的结局测量指标（PROM）：Oswestry 残疾指数（ODI）、改良 SRS-24 问卷、世界卫生组织生活质量指数（WHOQoL）、疼痛数字评分量表（NRS）进行回顾性比较研究。临床随访时间为 4.4（4.3）年，随访率为 95%。应用 χ 统计量和 t 检验进行 PROM 随访时间 26.4（2.8）年的比较。显著性阈值设为 P<0.05。
在 1531 例连续的白种人 AIS 患者中，年龄为 13.9（1.8）岁，主弯 29.2（11.5）度，120 例（7.8%）存在低等级的峡部 L5 滑脱，平均滑脱率为 15.0（8.3）%（研究组=S）。研究组的曲线类型分布与仅存在 AIS 的其余 1411 例患者相似。与入院时配对的对照组（C）相比，研究组有 4.2%的患者日常生活活动受腰痛干扰，对照组为 1.7%，在临床随访时分别为 2.6/4.2%（无统计学差异）。S/C 两组间在脊柱侧凸治疗方面无显著差异：观察治疗 38.3/45.8%，支具治疗 48.3/46.6%，手术治疗 10.8/10.2%。两组的治疗结果相当。长期结局（ODI、SRS-24、WHOQoL、NRS-腰背/下肢疼痛）也相似。
AIS 患者中低等级峡部 L5 脊柱滑脱的发生率为 7.8%。低等级峡部脊柱滑脱的存在既不影响 AIS 的曲线类型，也不影响病程或长期结局。这些幻灯片可在电子补充材料中查看。
