Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30, Gothenburg, Sweden.
Department of Physical Therapy, Sahlgrenska University Hospital, 413 45, Gothenburg, SE, Sweden.
Spine Deform. 2022 Sep;10(5):1085-1095. doi: 10.1007/s43390-022-00487-8. Epub 2022 Mar 23.
To determine long-term outcome in terms of spinal range of motion (ROM) and trunk muscle endurance (TME) patients treated for idiopathic scoliosis, diagnosed before the age of ten, were evaluated and compared with untreated or treated patients with idiopathic scoliosis with adolescent onset (AIS).
Sixty-three braced and 53 operated patients underwent examination of spinal ROM and TME. Validated questionnaires were used for evaluation of back function.
A total of 116 patients were examined 26.5 years after treatment. Braced EOS patients had longer bracing time and operated EOS patients had longer fusions compared to the respective AIS groups. Braced EOS patients had similar total ROM (thoracic ROM 40°, lumbar ROM 78°) and TME (trunk flexors 140 s, trunk extensors 255 s) as untreated AIS patients (thoracic ROM 34°, lumbar ROM 88°, trunk flexor endurance 158 s, trunk extensor endurance 234 s). Braced patients also had significantly better results than braced AIS patients. Operated EOS patients were slightly but significantly stronger and more mobile compared to AIS peers. The lumbar ROM was found to affect the back function in the operated EOS group (Oswestry Questionnaire, rs = 0.49, p < 0.001).
The braced EOS patients had mostly similar muscle strength and mobility as the untreated but younger AIS group, while the braced AIS group showed reductions of both strength and mobility. Similar significant, but small, differences were also found between operated EOS and AIS patients. Especially for muscle strength were findings at a level that would be of significant clinical importance.
III.
评估和比较特发性脊柱侧凸（EOS）患者和青少年特发性脊柱侧凸（AIS）患者的脊柱活动范围（ROM）和躯干肌肉耐力（TME）的长期结果。方法：63 名支具治疗和 53 名手术治疗的 EOS 患者接受了脊柱 ROM 和 TME 检查。使用经过验证的问卷评估背部功能。结果：共对 116 名患者进行了检查，随访时间为治疗后 26.5 年。与各自的 AIS 组相比，支具治疗的 EOS 患者支具治疗时间更长，手术治疗的 EOS 患者融合时间更长。支具治疗的 EOS 患者的总 ROM（胸椎 ROM40°，腰椎 ROM78°）和 TME（躯干屈肌 140s，躯干伸肌 255s）与未治疗的 AIS 患者相似（胸椎 ROM34°，腰椎 ROM88°，躯干屈肌耐力 158s，躯干伸肌耐力 234s）。支具治疗的 EOS 患者的结果也明显优于支具治疗的 AIS 患者。手术治疗的 EOS 患者的力量和活动度略高于 AIS 患者。研究发现，腰椎 ROM 影响手术治疗的 EOS 组的背部功能（Oswestry 问卷，rs=0.49，p<0.001）。结论：与未治疗的年轻 AIS 组相比，支具治疗的 EOS 患者的肌肉力量和活动度大多相似，而支具治疗的 AIS 组的力量和活动度均下降。手术治疗的 EOS 患者和 AIS 患者之间也发现了类似的、但较小的差异。尤其是肌肉力量的发现具有重要的临床意义。证据等级：III。
