Laverdière Carl, Georgiopoulos Miltiadis, Ames Christopher P, Corban Jason, Ahangar Pouyan, Awadhi Khaled, Weber Michael H
McGill University Faculty of Medicine, Scoliosis and Spinal Research Unit, Montreal, Quebec, Canada.
Department of Neurological Surgery, University of California, San Francisco, CA, USA.
Global Spine J. 2022 May;12(4):689-699. doi: 10.1177/21925682211004250. Epub 2021 Mar 26.
Systematic review.
Adult spinal deformity (ASD) can be a debilitating condition with a profound impact on patients' health-related quality of life (HRQoL). Many reports have suggested that the frailty status of a patient can have a significant impact on the outcome of the surgery. The present review aims to identify all pre-operative patient-specific frailty markers that are associated with postoperative outcomes following corrective surgery for ASD of the lumbar and thoracic spine.
A systematic review of the literature was performed to identify findings regarding pre-operative markers of frailty and their association with postoperative outcomes in patients undergoing ASD surgery of the lumbar and thoracic spine. The search was performed in the following databases: PubMed, Embase, Cochrane and CINAHL.
An association between poorer performance on frailty scales and worse postoperative outcomes. Comorbidity indices were even more frequently employed with similar patterns of association between increased comorbidity burden and postoperative outcomes. Regarding the assessment of HRQoL, worse pre-operative ODI, SF-36, SRS-22 and NRS were shown to be predictors of post-operative complications, while ODI, SF-36 and SRS-22 were found to improve post-operatively.
The findings of this review highlight the true breadth of the concept of "frailty" in ASD surgical correction. These parameters, which include frailty scales and various comorbidity and HRQoL indices, highlight the importance of identifying these factors preoperatively to ensure appropriate patient selection while helping to limit poor postoperative outcomes.
系统评价。
成人脊柱畸形（ASD）可能是一种使人衰弱的疾病，对患者的健康相关生活质量（HRQoL）有深远影响。许多报告表明，患者的虚弱状态可能对手术结果产生重大影响。本综述旨在确定所有与腰椎和胸椎ASD矫正手术后的术后结果相关的术前患者特异性虚弱标志物。
对文献进行系统评价，以确定有关虚弱术前标志物及其与接受腰椎和胸椎ASD手术患者术后结果的关联的研究结果。检索在以下数据库中进行：PubMed、Embase、Cochrane和CINAHL。
虚弱量表表现较差与术后结果较差之间存在关联。合并症指数甚至更频繁地被使用，合并症负担增加与术后结果之间的关联模式相似。关于HRQoL的评估，术前较差的ODI、SF-36、SRS-22和NRS被证明是术后并发症的预测指标，而ODI、SF-36和SRS-22在术后有所改善。
本综述的结果突出了ASD手术矫正中“虚弱”概念的真正广度。这些参数，包括虚弱量表以及各种合并症和HRQoL指数，突出了术前识别这些因素的重要性，以确保适当的患者选择，同时有助于限制不良的术后结果。
