Bastrom Tracey P, Bartley Carrie E, Newton Peter O
Rady Children's Hospital, 3020 Children's Way, San Diego, CA, 92123, USA.
Rady Children's Hospital, 3020 Children's Way, San Diego, CA, 92123, USA.
Spine Deform. 2019 Nov;7(6):917-922. doi: 10.1016/j.jspd.2019.01.007.
Observational.
To examine changes in patient-reported two-year postoperative outcomes via the Scoliosis Research Society (SRS)-24 Outcomes Instrument from 2001 through 2015.
Techniques for correction of adolescent idiopathic scoliosis (AIS) have evolved over the years, but it is unclear how these changes have impacted patient-reported outcomes.
AIS patients with two-year postoperative follow-up from a prospective multicenter registry were divided into three-year groups based on trends in surgical approach and construct type (2010-2014: 52% anterior, 43% posterior hybrids; 2005-2011: 3% anterior, 5% posterior hybrids; 2012-2015: 0% anterior, 0.2% posterior hybrids). Because of the ordinal scale (1-5) and bipolar nature of the response sets for the SRS-24, domain/total scores were categorized as ≤3 (predominantly negative) or 4-5 (predominantly positive). Variables were compared across the three groups.
A total of 1,695 patients were analyzed; 172 (2010-2014), 926 (2005-2011), and 597 (2012-2015). Average age was 14.7 ± 2 years, the average primary curve was 55° ± 13°, and the group was primarily female (82%). There was a decline in the rate of positive scores for preoperative pain and self-image across the three groups (p < .05). There was an increase in the rate of positive scores for two-year postoperative self-image after surgery, function after surgery, and satisfaction (p < .05). Decreases in length of hospital stay, blood loss, surgical time, preoperative kyphosis, and postoperative trunk shift were observed (p < .05). Increases were observed in levels fused, preoperative major coronal curve, preoperative rib prominence, preoperative trunk shift, percentage correction of major curve, kyphosis restoration, and the rate of double/triple curves (p < .05).
The percentage of patients with positive postoperative SRS scores has increased in the modern era, providing evidence that newer surgical techniques are resulting in improved outcomes based on the patients' perspectives. Interestingly, recent patients were more afflicted with negative pain and self-image before surgery.
观察性研究。
通过脊柱侧弯研究学会（SRS）-24 结局量表，研究 2001 年至 2015 年患者报告的术后两年结局变化。
多年来，青少年特发性脊柱侧弯（AIS）的矫正技术不断发展，但尚不清楚这些变化如何影响患者报告的结局。
对前瞻性多中心登记处中术后两年随访的 AIS 患者，根据手术方式和内固定类型的趋势分为三年一组（2010 - 2014 年：前路 52%，后路混合 43%；2005 - 2011 年：前路 3%，后路混合 5%；2012 - 2015 年：前路 0%，后路混合 0.2%）。由于 SRS - 24 的反应集为有序量表（1 - 5）且具有双极性，因此将领域/总分归类为≤3（主要为负面）或 4 - 5（主要为正面）。对三组变量进行比较。
共分析了 1695 例患者；分别为 172 例（2010 - 2014 年）、926 例（2005 - 2011 年）和 597 例（2012 - 2015 年）。平均年龄为 14.7±2 岁，平均主弯为 55°±13°，且该组主要为女性（82%）。三组患者术前疼痛和自我形象的正面评分率均有所下降（p <.05）。术后两年自我形象、术后功能和满意度的正面评分率有所上升（p <.05）。观察到住院时间、失血量、手术时间、术前后凸、术后躯干偏移均有所减少（p <.05）。融合节段数、术前主冠状面弯曲度、术前肋骨突出度、术前躯干偏移、主弯矫正百分比、后凸恢复以及双/三弯发生率均有所增加（p <.05）。
在现代，术后 SRS 评分呈阳性的患者比例有所增加，这表明从患者角度来看，更新的手术技术带来了更好的结局。有趣 的是，近期患者术前的疼痛和自我形象负面情况更为严重。
