Johnson Mitchell A, Cirrincione Peter M, Zucker Colson P, Blanco John S, Widmann Roger F, Heyer Jessica H
Hospital for Special Surgery, New York, NY, USA.
J Child Orthop. 2023 May 22;17(4):354-359. doi: 10.1177/18632521231177041. eCollection 2023 Aug.
Posterior spinal fusion for idiopathic scoliosis is known to increase spinal height, but the impacts on weight and resulting body mass index are unknown. This study assesses body mass index, weight, and height percentile changes over time after posterior spinal fusion for idiopathic scoliosis.
Body mass index, weight, and height age- and sex-adjusted percentiles for patients with idiopathic scoliosis undergoing posterior spinal fusion between January 2016 and August 2022 were calculated based on growth charts from the Centers for Disease Control for Disease Control and compared to preoperative values at 2 weeks, 3 months, 6 months, 1 year, and 2 years. The data were analyzed for normality with a Shapiro-Wilk test, and percentiles were compared with the Wilcoxon signed-rank tests.
On average, 12.1 ± 2.3 levels were fused in 269 patients 14.4 ± 1.9 years, and percentiles for body mass index, weight, and height preoperatively were 55.5 ± 29.4%, 57.5 ± 28.9%, and 54.6 ± 30.4%, respectively. Body mass index and weight percentiles decreased at 2 weeks (-10.7%, < 0.001; -4.6%, < 0.001, respectively) and 3 months (-6.9%, < 0.001; -3.2%, < 0.001, respectively) postoperatively. Postoperative weight loss at 2 weeks averaged 2.25 ± 3.09% of body weight (0.98 ± 4.5 kg), normalizing by 3 months. Body mass index percentile normalized at 1 year, but height percentile was increased at 2 weeks (2.42 ± 1.72 cm, < 0.001) and through 2 years.
Despite initial height increase due to deformity correction, acute postoperative weight and body mass index percentile decreases postoperatively normalize by 1-year body mass index percentile. Physicians may benefit from utilizing this information when discussing the postoperative course of posterior spinal fusion with idiopathic scoliosis.
4, Retrospective Case Series.
已知特发性脊柱侧凸后路脊柱融合术可增加脊柱高度，但对体重及由此产生的体重指数的影响尚不清楚。本研究评估特发性脊柱侧凸后路脊柱融合术后随时间推移体重指数、体重和身高百分位数的变化。
根据疾病控制中心的生长图表，计算2016年1月至2022年8月期间接受后路脊柱融合术的特发性脊柱侧凸患者的体重指数、体重以及年龄和性别调整后的身高百分位数，并与术前2周、3个月、6个月、1年和2年时的值进行比较。采用Shapiro-Wilk检验分析数据的正态性，并用Wilcoxon符号秩检验比较百分位数。
平均而言，269例14.4±1.9岁的患者融合了12.1±2.3个节段，术前体重指数、体重和身高的百分位数分别为55.5±29.4%、57.5±28.9%和54.6±30.4%。术后2周（分别为-10.7%，P<0.001；-4.6%，P<0.001）和3个月（分别为-6.9%，P<0.001；-3.2%，P<0.001）时，体重指数和体重百分位数下降。术后2周体重平均减轻2.25±3.09%（0.98±4.5kg），3个月时恢复正常。体重指数百分位数在1年时恢复正常，但身高百分位数在术后2周（2.42±1.72cm，P<0.001）及整个2年期间均升高。
尽管因畸形矫正最初身高增加，但术后急性体重和体重指数百分位数下降在1年内体重指数百分位数恢复正常。医生在与特发性脊柱侧凸患者讨论后路脊柱融合术的术后过程时，利用这些信息可能会有所帮助。
4，回顾性病例系列研究。
