后路脊柱融合术治疗青少年特发性脊柱侧凸术后 Lenke 分型、腰椎融合范围与健康相关生活质量的相关性。
Association Between Lenke Classification, The Extent of Lumbar Spinal Fusion, and Health-Related Quality of Life After Instrumented Spinal Fusion for Adolescent Idiopathic Scoliosis.
机构信息
Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.
出版信息
Spine (Phila Pa 1976). 2023 Sep 1;48(17):1216-1223. doi: 10.1097/BRS.0000000000004760. Epub 2023 Jun 21.
STUDY DESIGN
Prospective cohort study.
SUMMARY OF BACKGROUND DATA
Lenke classification is used to define the curve type in adolescent idiopathic scoliosis (AIS). The association of Lenke classification and long-term postoperative health-related quality of life (HRQoL) remains unclear.
OBJECTIVE
The purpose of this study was to assess the association between Lenke classification and HRQoL in patients who underwent spinal fusion for AIS.
MATERIALS AND METHODS
In all, 146 consecutive patients (mean age 15.1 yr) operated for AIS between 2007 and 2019 with a minimum 2-year follow-up were included. Fifty-three (36%) patients reached the 10-year follow-up. Their HRQoL was assessed with the SRS-24 questionnaire preoperatively, at six months, two years, and 10 years after surgery.
RESULTS
The preoperative major curve was the largest in Lenke 3 (mean 63 ° ) and 4 (mean 62 ° ) groups and the lowest in Lenke 5 groups (mean 48 ° , P <0.05). These curves were corrected to a mean of 15 ° with no differences between groups. We found no evidence of differences between the preoperative HRQoL scores between the Lenke groups. The self-image domain of SRS-24 was lower in patients with isolated major thoracolumbar scoliosis (Lenke 5) when compared with double-thoracic (Lenke 2) group at the two-year follow-up (mean [95% CI] 3.6 [3.3-3.9] vs. 4.3 [4.1-4.6]). The postoperative satisfaction domain was lower in Lenke 5 group when compared with main thoracic (Lenke 1) group (mean [95% CI] 3.8 [3.5-4.0] vs. 4.3 [4.2-4.5]) and Lenke 2 group (mean 4.4, 95% CI 4.2-4.6) at the two-year follow-up. The mean total score of SRS-24 at the 10-year follow-up was highest in Lenke 1 group (mean 4.06, 95% CI 3.79-4.33) and lowest in Lenke 6 group (mean 2.92, 95% CI 2.22-3.61).
CONCLUSIONS
Lenke classification and especially its curve type (major thoracic vs. major thoracolumbar scoliosis) was associated with long-term health-related quality of life after instrumented spinal fusion for AIS.
研究设计
前瞻性队列研究。
摘要背景数据
Lenke 分类用于定义青少年特发性脊柱侧凸（AIS）的曲线类型。Lenke 分类与长期术后健康相关生活质量（HRQoL）之间的关联尚不清楚。
目的
本研究旨在评估接受脊柱融合术治疗 AIS 的患者中 Lenke 分类与 HRQoL 的关系。
材料与方法
共纳入 2007 年至 2019 年间接受 AIS 脊柱融合术治疗且随访至少 2 年的 146 例连续患者（平均年龄 15.1 岁）。其中 53 例（36%）达到 10 年随访。术前、术后 6 个月、2 年和 10 年使用 SRS-24 问卷评估他们的 HRQoL。
结果
术前主弯中 Lenke 3（平均 63°）和 4 组（平均 62°）最大，Lenke 5 组最小（平均 48°，P<0.05）。各组间无差异，术后均矫正至平均 15°。我们发现 Lenke 组间术前 HRQoL 评分无差异。与双胸段（Lenke 2）组相比，单纯胸腰椎段脊柱侧凸（Lenke 5）患者 SRS-24 的自我形象域在两年随访时较低（平均[95%CI]3.6[3.3-3.9]vs.4.3[4.1-4.6]）。与主胸段（Lenke 1）组（平均[95%CI]4.3[4.2-4.5]）和 Lenke 2 组（平均 4.4，95%CI 4.2-4.6）相比，术后满意度域在两年随访时在 Lenke 5 组中较低。在 10 年随访时，SRS-24 的总分在 Lenke 1 组中最高（平均 4.06，95%CI 3.79-4.33），在 Lenke 6 组中最低（平均 2.92，95%CI 2.22-3.61）。
结论
Lenke 分类，尤其是其曲线类型（主胸段 vs. 主胸腰椎段脊柱侧凸）与 AIS 后路内固定术后长期健康相关生活质量相关。
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