Department of Orthopaedic, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
J Orthop Surg Res. 2019 Sep 3;14(1):290. doi: 10.1186/s13018-019-1339-y.
To evaluate the predictive effect of lumbar lordosis minus thoracic kyphosis (LL-TK) in the surgical outcome of adult degenerative scoliosis (ADS) patients and explore the optimum target base on it.
The preoperative and postoperative data including radiographic image and functional evaluation (Visual Analog Scale, VAS; Oswestry Disability Index, ODI; Japanese Orthopaedic Association, JOA) of 130 patients with ADS who underwent corrective surgery was retrospectively reviewed. The relationship between sagittal parameters and surgical outcome was assessed by using the Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to define the optimum cutoff value of LL-TK. Patients were divided into two groups based on LL-TK to compare the preoperative and postoperative status.
LL-TK assessed soon after surgery strongly correlated with health-related quality of life (HRQOL) and sagittal vertical axis (SVA) at last follow-up. The cutoff value of LL-TK was set at 10° to determine a good clinical outcome (ODI < 20) and sagittal balance (SVA < 50 mm). Patients with LL-TK > 10° presented significantly better postoperative VAS, ODI, JOA, and SVA than patients with LL-TK < 10°.
LL-TK could effectively predict postoperative HRQOL and sagittal balance for patients with ADS. Patients with LL-TK > 10° showed a better clinical outcome and sagittal balance, so LL-TK > 10° could be the optimum corrective target for these patients.
评估腰椎前凸减去胸椎后凸（LL-TK）在成人退行性脊柱侧凸（ADS）患者手术结果中的预测效果，并在此基础上探讨最佳目标。
回顾性分析了 130 例接受矫形手术的 ADS 患者的术前和术后数据，包括影像学图像和功能评估（视觉模拟评分，VAS；Oswestry 功能障碍指数，ODI；日本矫形协会，JOA）。使用 Pearson 相关分析评估矢状参数与手术结果的关系。使用受试者工作特征（ROC）曲线确定 LL-TK 的最佳截断值。根据 LL-TK 将患者分为两组，比较术前和术后状态。
术后即刻测量的 LL-TK 与健康相关生活质量（HRQOL）和最终随访时的矢状垂直轴（SVA）强烈相关。将 LL-TK 的截断值设定为 10°，以确定良好的临床结果（ODI<20）和矢状平衡（SVA<50mm）。LL-TK>10°的患者术后 VAS、ODI、JOA 和 SVA 明显优于 LL-TK<10°的患者。
LL-TK 可有效预测 ADS 患者术后 HRQOL 和矢状平衡。LL-TK>10°的患者表现出更好的临床结果和矢状平衡，因此 LL-TK>10°可能是这些患者的最佳矫正目标。
