UOSD Spinal Deformity Center, AOU Consorziale "Policlinico", Bari, Italy.
Orthopaedic and Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Spine Unit, University of Bari Aldo Moro, AOU Consorziale "Policlinico", Piazza Giulio Cesare 11, 70214, Bari, Italy.
Spine Deform. 2022 Jul;10(4):855-863. doi: 10.1007/s43390-022-00479-8. Epub 2022 Feb 8.
To assess the self-image perception and the Quality-of-Life (QoL) in female adolescents, with Lenke 1C scoliosis curves, treated with selective versus non-selective posterior spinal instrumentation and fusion (PSF).
Patients undergoing PSF for idiopathic adolescent scoliosis (AIS) were recruited and divided into two groups: patients managed with selective thoracic fusion (STF) were included in Group A, whereas patients treated with non-selective fusion (N-STF) in Group B. Each patient completed the Italian version of the Scoliosis Research Society-22R questionnaire (SRS-22R), the Quality-of-Life Profile for Spinal Deformities questionnaire (QLPSD) and the Spinal Appearance Questionnaire (SAQ), before surgery and at 24-month follow-up.
One hundred and fifty seven female patients (mean age 16.38) were included in this study. 80 patients underwent STF, while 77 patients received N-STF. At 24-month follow-up, patients managed with N-STF showed better SRS-22R self-image mean score (p = .012), SRS-22R satisfaction mean score (p = .033), QLPSD body image mean score (p = .005), but worse SRS-22 function mean score (p = .006) and QLPSD back flexibility mean score (p = .007), compared with patients who underwent STF. In terms of self-image perception, patients undergoing STF showed significantly worse SAQ total mean score (p = .002), SAQ appearance mean score (p = .001) and SAQ expectation (p = .001). We found a significant correlation between SAQ appearance mean score and SRS-22R self-image (R = - 0.721), SRS-22 mental health (R = - 0.8), QLPSD psychosocial functioning (R = 0.7) and QLPSD back flexibility (R = 0.8).
Although the STF of Lenke 1C curves provides better functional outcomes, in the present study, female patients receiving STF revealed a worse perceived body image, compared with patients treated with N-STF, at 24-month follow-up. Particular attention should be addressed to the preoperative patient's mental health and body image perception, when choosing between STF and N-STF.
评估 Lenke 1C 型脊柱侧凸女性青少年的自我形象感知和生活质量（QoL），并比较选择性与非选择性后路脊柱内固定融合术（PSF）的治疗效果。
招募接受 PSF 治疗特发性青少年脊柱侧凸（AIS）的患者，并将其分为两组：接受选择性胸椎融合术（STF）的患者纳入 A 组，接受非选择性融合术（N-STF）的患者纳入 B 组。每位患者在术前和 24 个月随访时完成意大利版脊柱侧凸研究协会 22R 问卷（SRS-22R）、脊柱畸形生活质量问卷（QLPSD）和脊柱外观问卷（SAQ）。
本研究共纳入 157 例女性患者（平均年龄 16.38 岁）。80 例患者接受 STF，77 例患者接受 N-STF。24 个月随访时，N-STF 组患者的 SRS-22R 自我形象平均评分（p=0.012）、SRS-22R 满意度平均评分（p=0.033）、QLPSD 身体形象平均评分（p=0.005）更高，但 SRS-22R 功能平均评分（p=0.006）和 QLPSD 背部灵活性平均评分（p=0.007）更差，与接受 STF 治疗的患者相比。在自我形象感知方面，接受 STF 治疗的患者的 SAQ 总分平均评分（p=0.002）、SAQ 外观平均评分（p=0.001）和 SAQ 期望平均评分（p=0.001）明显更差。我们发现 SAQ 外观平均评分与 SRS-22R 自我形象（R=-0.721）、SRS-22R 心理健康（R=-0.8）、QLPSD 心理社会功能（R=0.7）和 QLPSD 背部灵活性（R=0.8）显著相关。
尽管 Lenke 1C 型曲线的 STF 提供了更好的功能结果，但在本研究中，接受 STF 治疗的女性患者在 24 个月随访时，与接受 N-STF 治疗的患者相比，自我感知的身体形象更差。在选择 STF 与 N-STF 时，应特别注意术前患者的心理健康和身体形象感知。
