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比较磁控生长棒和传统生长棒治疗早发性脊柱侧凸患者的健康相关生活质量和护理负担:一项多中心研究。

Comparing health-related quality of life and burden of care between early-onset scoliosis patients treated with magnetically controlled growing rods and traditional growing rods: a multicenter study.

机构信息

Columbia University Medical Center, New York, NY, USA.

Children's Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd., MS #69, Los Angeles, CA, 90027, USA.

出版信息

Spine Deform. 2021 Jan;9(1):239-245. doi: 10.1007/s43390-020-00173-7. Epub 2020 Aug 26.

Abstract

STUDY DESIGN

Multicenter retrospective cohort study.

OBJECTIVES

To compare pre-operative and post-operative EOSQ-24 scores in magnetically controlled growing rods (MCGR) and traditional growing rod (TGR) patients. Since the introduction of MCGR, early-onset scoliosis patients have been afforded a reduction in the number of surgeries compared to the TGR technique. However, little is known about (health-related quality of life) and burden of care outcomes between these surgical techniques.

METHODS

This is a retrospective cohort study using a multicenter registry on patients with EOS undergoing MCGR or TGR between 2008 and 2017. The EOSQ-24 was administered at preoperative and postoperative 2-year assessments. The EOSQ-24 scores were compared between MCGR and TGR as well as preoperatively and postoperatively within each procedure.

RESULTS

110 patients were analyzed in this study (TGR, N = 32; MCGR, N = 78). There were no significant differences in preoperative age, gender, etiology, main coronal curve or maximum kyphosis between TGR and MCGR groups. Patients with TGR had averaged 3.9 surgical lengthenings and MCGR had averaged 7.7 non-invasive lengthenings by the 2-year follow-up. When changes in preoperative to postoperative scores were compared, MCGR had more improvements in pain, emotion, child satisfaction and parent satisfaction than TGR although there were no statistical significance. When analyzed separately, MCGR cohort had improvement in scores for all four domains and four sub-domains; while, TGR cohort only had improvement in financial burden domain and pulmonary function sub-domain.

CONCLUSION

Although there was no statistical significance, the improvement in pain, emotion and satisfaction scores was larger in MCGR than TGR. Since these areas can be influenced more by mental well-being than other sub-domains, the results may prove our hypothesis that compared to TGR, MCGR with reduced number of surgeries have better psychosocial effects.

LEVEL OF EVIDENCE

III.

摘要

研究设计

多中心回顾性队列研究。

目的

比较磁控生长棒(MCGR)和传统生长棒(TGR)患者术前和术后 EOSQ-24 评分。自从 MCGR 问世以来,与 TGR 技术相比,早期发病的脊柱侧凸患者的手术次数有所减少。然而,对于这些手术技术之间的(健康相关生活质量)和护理负担结果知之甚少。

方法

这是一项使用多中心注册处对 2008 年至 2017 年间接受 MCGR 或 TGR 的 EOS 患者进行的回顾性队列研究。在术前和术后 2 年评估时使用 EOSQ-24 进行评估。比较 MCGR 和 TGR 之间以及每种手术方法的术前和术后的 EOSQ-24 评分。

结果

本研究分析了 110 例患者(TGR,N=32;MCGR,N=78)。TGR 和 MCGR 组之间在术前年龄、性别、病因、主要冠状曲度或最大后凸方面无显著差异。到 2 年随访时,TGR 患者的平均手术延长次数为 3.9 次,MCGR 患者的平均非侵入性延长次数为 7.7 次。比较术前至术后评分的变化时,尽管无统计学意义,但 MCGR 在疼痛、情绪、患儿满意度和家长满意度方面的改善优于 TGR。单独分析时,MCGR 组在四个领域和四个子领域的评分均有所提高;而 TGR 组仅在经济负担领域和肺功能子领域的评分有所提高。

结论

尽管无统计学意义,但 MCGR 在疼痛、情绪和满意度评分方面的改善优于 TGR。由于这些领域可能比其他子领域受心理健康的影响更大,因此结果可能证明我们的假设,即与 TGR 相比,手术次数减少的 MCGR 具有更好的心理社会影响。

证据水平

III。

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