早发性脊柱侧凸手术将如何影响我的孩子作为年轻成年人的未来?一项使用患者报告结局测量的随访研究。
How will early onset scoliosis surgery affect my child's future as a young adult? A follow-up study using patient-reported outcome measures.
机构信息
Campbell Clinic, Department of Orthopaedics, University of Tennessee, Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA.
Gillette Children's Pediatric Orthopedics, Saint Paul, MN, USA.
出版信息
Spine Deform. 2024 Nov;12(6):1813-1822. doi: 10.1007/s43390-024-00910-2. Epub 2024 Jun 10.
PURPOSE
Using patient-reported outcome measures (PROMs), this study was undertaken to determine how well patients with early onset scoliosis (EOS) fare in adulthood.
METHODS
Among eight healthcare centers, 272 patients (≥ 18 years) surgically managed for EOS (≥ 5 years) completed the Scoliosis Research Society (SRS)-22r, Functional Assessment of Chronic Illness Therapy-10 (FACIT-Dyspnea-10), and Short Form (SF)-12. Functional and demographic data were collected.
RESULTS
The response rate was 40% (108/272). EOS etiologies were congenital (45%), neuromuscular (20%), idiopathic (20%) syndromic (11%), and unknown (4%). All patients scored within normal limits on the FACIT-Dyspnea-10 pulmonary (no breathing aids, 78%; no oxygen, 92%). SF-12 physical health scores and most SRS-22r domains were significantly decreased (p < 0.05 and p < 0.001, respectively) compared with normative values. SF-12 and SRS-22r mental health scores (MHS) were lower than normative values (p < 0.05 and p < 0.02, respectively). Physical health PROMs varied between etiologies. Treatment varied by etiology. Patients with congenital EOS were half as likely to undergo definitive fusion. There was no difference between EOS etiologies in SF-12 MHS, with t scores being slightly lower than normative peers.
CONCLUSION
Good long-term physical and social function and patient-reported quality of life were noted in surgically managed patients. Patients with idiopathic EOS physically outperformed those with other etiologies in objective and PROM categories but had similar MHS PROMs. Compared to normative values, EOS patients demonstrated decreased long-term physical capacity, slightly lower MHS, and preserved cardiopulmonary function.
LEVEL OF EVIDENCE
Level IV Case Series.
目的
本研究通过使用患者报告的结局测量(PROMs)来确定早发性脊柱侧凸(EOS)患者在成年后表现如何。
方法
在 8 个医疗中心中,272 名(≥18 岁)接受手术治疗的 EOS(≥5 年)患者完成了 Scoliosis Research Society(SRS)-22r、慢性疾病治疗功能评估-10(FACIT-Dyspnea-10)和简短表格(SF)-12。收集了功能和人口统计学数据。
结果
响应率为 40%(108/272)。EOS 的病因包括先天性(45%)、神经肌肉(20%)、特发性(20%)、综合征(11%)和未知(4%)。所有患者在 FACIT-Dyspnea-10 肺功能(无呼吸辅助,78%;无氧气,92%)上的得分均在正常范围内。SF-12 生理健康评分和大多数 SRS-22r 领域的评分均显著低于正常值(p<0.05 和 p<0.001)。SF-12 和 SRS-22r 心理健康评分(MHS)低于正常值(p<0.05 和 p<0.02)。生理健康 PROMs 在不同病因之间存在差异。治疗方法因病因而异。先天性 EOS 患者接受确定性融合的可能性是其他病因的一半。在 SF-12 MHS 中,EOS 病因之间没有差异,t 分数略低于正常同龄人。
结论
在接受手术治疗的患者中,观察到了良好的长期生理和社会功能以及患者报告的生活质量。在客观和 PROM 类别中,特发性 EOS 患者的身体表现优于其他病因患者,但 MHS PROMs 相似。与正常值相比,EOS 患者的长期身体能力下降,MHS 略低,心肺功能正常。
证据水平
IV 级病例系列。