Fekete Tamás F, Mannion Anne F, Haschtmann Daniel, Loibl Markus, Kleinstück Frank S, Jeszenszky Dezső J
Spine Center, Schulthess Klinik, Lengghalde 2, 8008 Zurich, Switzerland.
Spine Center, Schulthess Klinik, Lengghalde 2, 8008 Zurich, Switzerland.
Spine Deform. 2019 Sep;7(5):754-758. doi: 10.1016/j.jspd.2019.02.004.
A retrospective analysis of prospectively collected data from patients aged 12-30 years, operated for AIS in our hospital from 2005 to 2014 and registered in our local patient outcomes database linked to EUROSPSINE's Spine Tango Registry.
To investigate whether in patients with AIS and notable back pain surgery is associated with significant pain relief and whether age influences outcome.
Few studies have investigated the association between adolescent idiopathic scoliosis and back pain and the influence of age on the relief of back pain after surgical correction of the deformity.
Preoperatively and up to two years' postoperatively, patients completed the Core Outcome Measures Index, which includes two 0-10 scales for back pain and leg/buttock pain. A score of 4/10 or more is considered "relevant pain."
We identified 85 patients with AIS (74 (87%) females) in the database; 60 were aged 12-18 years (mean 15.5 ± 1.7 years) and 25 were 19-30 years (mean 22.5 ± 3.1 years). There were no significant differences (p > .05) between the age groups for coronal Cobb angles of the main curves or Lenke curve types, and these curves showed no correlation with pain intensity (p > .05). Back pain was correlated with age (r = 0.31, p = .004). Preoperatively, 42% patients had a back pain score of ≥4/10 (52% in adults, 38% in adolescents). Just 8% patients had a leg pain score of ≥4/10 (16% in adults, 5% in adolescents). Those with notable back pain showed a significant (p < .0001) improvement two years after surgery. However, 24% of patients with no back pain at baseline showed a worsening of pain by 2 (out of 10) points or more two years postoperatively. There was no significant difference in the extent of improvement in older and younger patients (p = .22).
In patients undergoing surgery for correction of AIS, back pain is correlated with age. In those with relevant back pain at baseline, surgery is associated with a statistically significant and clinically relevant reduction of pain 24 months later, in skeletally mature young adults and adolescents alike.
Level III.
对2005年至2014年在我院接受手术治疗的12至30岁特发性脊柱侧凸（AIS）患者的前瞻性收集数据进行回顾性分析，这些数据已录入与EUROSPSINE的脊柱探戈注册中心相关联的本地患者结局数据库。
研究AIS且伴有明显背痛的患者手术是否能显著缓解疼痛，以及年龄是否会影响手术效果。
很少有研究调查青少年特发性脊柱侧凸与背痛之间的关联，以及年龄对畸形手术矫正后背痛缓解的影响。
术前及术后两年内，患者完成核心结局指标指数，该指数包括两个0至10分的背痛和腿/臀部疼痛评分量表。评分4/10分及以上被视为“相关疼痛”。
我们在数据库中识别出85例AIS患者（74例（87%）为女性）；60例年龄在12至18岁（平均15.5±1.7岁），25例年龄在19至30岁（平均22.5±3.1岁）。两组患者主弯的冠状面Cobb角或Lenke曲线类型无显著差异（p>.05），且这些曲线与疼痛强度无相关性（p>.05）。背痛与年龄相关（r = 0.31，p = .004）。术前，42%的患者背痛评分≥4/10（成人中为52%，青少年中为38%）。仅有8%的患者腿痛评分≥4/10（成人中为16%，青少年中为5%）。有明显背痛的患者术后两年疼痛有显著改善（p < .0001）。然而，24%基线时无背痛的患者术后两年疼痛加重2分（满分10分）或更多。老年和年轻患者的改善程度无显著差异（p = .22）。
在接受AIS矫正手术的患者中，背痛与年龄相关。对于基线时有相关背痛的患者，无论骨骼成熟的年轻人还是青少年，手术在24个月后均能在统计学上显著且临床上切实地减轻疼痛。
三级。
