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手握力对成人脊柱畸形手术后手术结果的影响。

Influence of Hand Grip Strength on Surgical Outcomes After Surgery for Adult Spinal Deformity.

机构信息

Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Bundang-gu, Sungnam, Republic of Korea.

Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea.

出版信息

Spine (Phila Pa 1976). 2020 Nov 15;45(22):E1493-E1499. doi: 10.1097/BRS.0000000000003636.

Abstract

STUDY DESIGN

A prospective observational study.

OBJECTIVE

This study was done to examine the influence of hand grip strength (HGS) on surgical outcomes of adult spinal deformity (ASD) patients.

SUMMARY OF BACKGROUND DATA

No study has investigated the relation between hand grip strength and treatment outcome of adult spinal deformity correction surgery.

METHODS

A total of 78 consecutive patients who underwent adult spinal deformity correction surgery were included in this study. Patients were assigned to either the high HGS (≥ 26 kg for men and ≥ 18 kg for women, n = 26) or the low HGS (< 26 kg for men and < 18 kg for women, n = 52) based on their preoperative measurements. The Oswestry disability index (ODI), EQ-5D, and visual analog scale (VAS) for back pain were assessed preoperatively, and 3 months, 6 months, and 12 months postoperatively. The primary outcome measure was ODI scores 12 months after surgery. The secondary outcome measures included the overall ODI scores, EQ-5D, and VAS for back pain, assessed at each time point during the 12-months follow-up.

RESULTS

The ODI score at 12 months after surgery was significantly lower in the high HGS group than the low HGS group (P < 0.001), which was best predicted by a multivariate regression model including age, gender, BMI, HGS, and preoperative ODI scores. The overall ODI score, EQ-5D, and VAS for back pain had better outcomes in the high HGS group across each follow-up assessment (P < 0.001 for all follow-ups), while they improved significantly with time after surgery in both groups.

CONCLUSIONS

Patients with higher preoperative HGS displayed better surgical outcomes, in terms of disability and health-related quality of life at 12 months after reconstructive spinal surgery for ASD.

LEVEL OF EVIDENCE

摘要

研究设计

前瞻性观察研究。

目的

本研究旨在探讨手握力(HGS)对成人脊柱畸形(ASD)患者手术结果的影响。

背景资料概要

尚无研究调查手握力与成人脊柱畸形矫正手术治疗结果之间的关系。

方法

本研究共纳入 78 例接受成人脊柱畸形矫正手术的连续患者。根据术前测量结果,患者被分为高 HGS(男性≥26kg,女性≥18kg,n=26)或低 HGS(男性<26kg,女性<18kg,n=52)组。在术前以及术后 3 个月、6 个月和 12 个月评估 Oswestry 残疾指数(ODI)、EQ-5D 和腰背疼痛视觉模拟评分(VAS)。主要观察指标为术后 12 个月时的 ODI 评分。次要观察指标包括每个时间点的总 ODI 评分、EQ-5D 和腰背疼痛 VAS。

结果

术后 12 个月时,高 HGS 组的 ODI 评分明显低于低 HGS 组(P<0.001),这一结果可通过包括年龄、性别、BMI、HGS 和术前 ODI 评分在内的多变量回归模型来最佳预测。在每个随访评估中,高 HGS 组的总 ODI 评分、EQ-5D 和腰背疼痛 VAS 均具有更好的结果(所有随访均 P<0.001),而两组在手术后时间推移中均显著改善。

结论

在 ASD 重建性脊柱手术后 12 个月,术前 HGS 较高的患者在残疾和健康相关生活质量方面表现出更好的手术结果。

证据等级

2 级。

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