Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Division of Surgical Care, Morimachi, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan.
Spine Deform. 2024 Jul;12(4):1079-1088. doi: 10.1007/s43390-024-00850-x. Epub 2024 Mar 25.
Waist line asymmetry is a major cosmetic concern in patients with adolescent idiopathic scoliosis (AIS). The primary surgical goal in patients with AIS is to correct spinal deformities and prevent further progression while maintaining global alignment. Additionally, an important objective of surgical treatment is to address physical appearance by reducing asymmetry. This study aimed to evaluate changes in waistline asymmetry using digital photographs in adolescents with thoracolumbar/lumbar (TL/L) scoliosis who underwent corrective surgery.
We retrospectively analyzed the data of patients with Lenke types 5C and 6C AIS who underwent posterior fusion surgery with at least 2 years of follow-up. Waist line asymmetry was assessed using digital photography. The waist angle ratio (WAR), waist height angle (WHA), and waistline depth ratio (WLDR) were measured pre- and postoperatively. Radiographic parameters and the revised 22-item Scoliosis Research Society Questionnaire (SRS-22r) were also evaluated.
Forty-two patients (40 females and 2 males; 34 with type 5C and 8 with type 6C) were included in the study. The WAR, WHA, and WLDR significantly improved after surgery (0.873 → 0.977, - 2.0° → 1.4°, and 0.321 → 0.899, respectively). Every waistline parameter moderately correlated with the apical vertebral translation of the TL/L curve (WAR: r = - 0.398, WHA: r = - 0.442, and WLDR: r = - 0.692), whereas no correlations were observed with the TL/L curve magnitude. No correlations were observed between the photographic parameters and SRS-22r scores.
Lateral displacement of the apical vertebra on the TL/L curve correlated with waistline asymmetry. Preoperative waistline asymmetry improved with scoliosis correction.
Level 4.
腰侧不对称是青少年特发性脊柱侧凸（AIS）患者的主要美容关注点。AIS 患者的主要手术目标是矫正脊柱畸形并防止进一步进展，同时保持整体对齐。此外，手术治疗的一个重要目标是通过减少不对称来改善外观。本研究旨在评估接受后路融合矫正手术的青少年胸腰段/腰椎段（TL/L）脊柱侧凸患者的腰围线不对称性变化。
我们回顾性分析了接受后路融合手术且至少随访 2 年的 Lenke 型 5C 和 6C AIS 患者的数据。使用数字摄影术评估腰围线不对称情况。术前和术后测量腰围角度比（WAR）、腰围高度角（WHA）和腰围深度比（WLDR）。还评估了影像学参数和修订后的 22 项脊柱侧凸研究协会问卷（SRS-22r）。
研究纳入了 42 名患者（40 名女性和 2 名男性；34 名 5C 型，8 名 6C 型）。手术后 WAR、WHA 和 WLDR 显著改善（0.873→0.977，-2.0°→1.4°和 0.321→0.899）。每个腰围参数与 TL/L 曲线的顶椎椎体平移中度相关（WAR：r=-0.398，WHA：r=-0.442，WLDR：r=-0.692），而与 TL/L 曲线幅度无关。摄影参数与 SRS-22r 评分之间无相关性。
TL/L 曲线上顶椎的侧向移位与腰围线不对称有关。术前腰围线不对称随脊柱侧凸矫正而改善。
4 级。
