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后路矫形融合术治疗青少年特发性脊柱侧凸术后生活质量是否受未经手术治疗的伴发低度峡部裂性脊柱滑脱的影响?一项回顾性队列研究。

Is quality of life after surgery for adolescent idiopathic scoliosis affected by the presence of a concomitant low-grade isthmic spondylolisthesis non-surgically treated? A retrospective cohort study.

机构信息

Université de Montréal, Montréal, QC, H3T 1C5, Canada.

CHU Sainte-Justine, Montréal, QC, Canada.

出版信息

Eur Spine J. 2022 Nov;31(11):3042-3049. doi: 10.1007/s00586-022-07281-0. Epub 2022 Aug 22.

DOI:10.1007/s00586-022-07281-0
PMID:35994113
Abstract

PURPOSE

The HRQoL after surgery for adolescent idiopathic scoliosis (AIS) is not affected by the presence of concomitant isthmic spondylolisthesis non-surgically treated. Improvement in QoL after surgery was similar for AIS patients with and without concomitant spondylolisthesis. The purpose is to compare preoperative and postoperative Health-Related Quality of Life (HRQoL) scores in operated AIS patients with and without concomitant isthmic spondylolisthesis.

METHODS

A retrospective study of a prospective cohort of 464 individuals undergoing AIS surgery between 2008 and 2018 was performed. All patients undergoing surgery for AIS with a minimum 2-year follow-up were included. We excluded patients with prior or concomitant surgery for spondylolisthesis. HRQoL scores were measured using the SRS-22 questionnaire. Comparisons were performed between AIS patients with versus without concomitant spondylolisthesis treated non-surgically.

RESULTS

AIS surgery was performed for 36 patients (15.2 ± 2.5 y.o) with concomitant isthmic spondylolisthesis, and 428 patients (15.5 ± 2.4 y.o) without concomitant spondylolisthesis. The two groups were similar in terms of age, sex, preoperative and postoperative Cobb angles. Preoperative and postoperative HRQoL scores were similar between the two groups. HRQoL improved significantly for all domains in both groups, except for pain in patients with spondylolisthesis. There was no need for surgical treatment of the spondylolisthesis and no slip progression during the follow-up duration after AIS surgery.

CONCLUSION

Patients undergoing surgical treatment of AIS with non-surgical management of a concomitant isthmic grade I spondylolisthesis can expect improvement in HRQoL scores, similar to that observed in patients without concomitant spondylolisthesis.

摘要

目的

青少年特发性脊柱侧凸(AIS)手术后的生活质量(HRQoL)不受未经手术治疗的伴发性峡部裂性脊柱滑脱的影响。手术后生活质量的改善在伴发性和不伴发性脊柱滑脱的 AIS 患者中相似。本研究旨在比较伴发性和不伴发性峡部裂性脊柱滑脱的 AIS 手术患者的术前和术后健康相关生活质量(HRQoL)评分。

方法

对 2008 年至 2018 年期间接受 AIS 手术的 464 名患者进行了前瞻性队列的回顾性研究。所有接受 AIS 手术且随访时间至少 2 年的患者均纳入研究。排除了既往或同时接受过脊柱滑脱手术的患者。HRQoL 评分采用 SRS-22 问卷进行测量。比较伴发性和不伴发性未手术治疗的脊柱滑脱的 AIS 患者之间的差异。

结果

36 例(15.2±2.5 岁)AIS 患者伴发伴发性峡部裂性脊柱滑脱,428 例(15.5±2.4 岁)患者无伴发性脊柱滑脱。两组患者在年龄、性别、术前和术后 Cobb 角方面相似。两组患者的术前和术后 HRQoL 评分相似。两组患者所有领域的 HRQoL 均显著改善,除了伴发滑脱的患者的疼痛外。在 AIS 手术后的随访期间,无需对脊柱滑脱进行手术治疗,也没有出现滑脱进展。

结论

对于接受 AIS 手术治疗且伴发性峡部裂性脊柱滑脱采用非手术治疗的患者,可以预期 HRQoL 评分得到改善,与不伴发性脊柱滑脱的患者相似。

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