Pereira-Duarte Matias, Joncas Julie, Labelle Hubert, Chémaly Olivier, Brassard Félix, Mac-Thiong Jean-Marc, Barchi Soraya, Parent Stefan
Université de Montréal, Montreal, Canada.
Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de La Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
Spine Deform. 2024 Nov;12(6):1675-1682. doi: 10.1007/s43390-024-00902-2. Epub 2024 Jun 27.
Since the outbreak of the COVID-19 pandemic, reduction of social activities and rapid adoption of telemedicine, decreasing face-to-face encounters seems to have negatively affected the timely Idiopathic Scoliosis (IS) referral with a spine specialist. We aim to document the progression of IS curves during COVID-19 pandemic reflected by the late presentation of patients at the initial visit with higher Cobb angles and to evaluate its influence on health-related quality of life scores.
All IS patients scheduled for surgery between April 2019 and September 2021 were recruited in a prospective cohort study. The patients were divided into five cohorts of 6 month duration each according to their booking date: 2 periods before the 1st COVID-19 wave, one period during and two periods afterwards. In each cohort, patients were divided into 3: those who were scheduled for posterior spinal fusion (PSF) at 1st visit, those booked for vertebral body tethering (VBT) at 1st visit, and those scheduled for surgery but who have failed brace treatment. Variables included age, gender, Risser grade and preoperative SRS-22 scores. Chi and ANOVA tests were used for comparison.
173 patients were analyzed. 33 patients (13.1 ± 3 y.o.) were scheduled between Apr and Sept 2019; 38 (13.1 y.o. ± 2) between Oct 2019 and Mar 2020; 31 (13.4 ± 3 y.o.) between Apr and Sept 2020; 30 (14.3 ± 2 y.o.) between Sept 2020 and Mar 2021; and 41 patients (13.8 ± 2 y.o.) between Apr and Sept 2021. Non-statistically significant differences were found between periods before, during or after the COVID-19 first wave regarding patients' age, gender, Risser grade and SRS-22 scores. Average Cobb angles of patients at their 1st visit after the beginning of the COVID-19 pandemic were significantly higher than those before COVID-19 (52.2° ± 7° and 56.6° ± 13° vs 47.8° ± 12° and 45.2° ± 13°; p = 0.0001). More patients were booked for PSF (p < 0.0000) through the five evaluated periods, while the indication of VBT or surgery in patients previously braced progressively decreased.
Patients presented at the scoliosis clinic for the 1st time after the 1st COVID-19 wave with significantly larger Cobb angles, and likely contributed to an increased proportion of PSF, as the potential window for bracing or VBT was missed due to a delayed consultation.
自新冠疫情爆发以来，社交活动减少以及远程医疗的迅速采用，面对面接触的减少似乎对特发性脊柱侧凸（IS）患者及时转诊至脊柱专科医生产生了负面影响。我们旨在记录新冠疫情期间IS曲线的进展情况，这体现在患者初次就诊时Cobb角更大的延迟就诊上，并评估其对健康相关生活质量评分的影响。
在一项前瞻性队列研究中招募了2019年4月至2021年9月期间计划接受手术的所有IS患者。根据预约日期，将患者分为五个队列，每个队列持续6个月：新冠疫情第一波之前的2个时期、疫情期间的1个时期以及之后的2个时期。在每个队列中，患者分为三组：初次就诊时计划接受后路脊柱融合术（PSF）的患者、初次就诊时预约椎体牵张术（VBT）的患者以及计划接受手术但支具治疗失败的患者。变量包括年龄、性别、Risser分级和术前SRS - 22评分。采用卡方检验和方差分析进行比较。
共分析了173例患者。2019年4月至9月期间安排了33例患者（13.1±3岁）；2019年10月至2020年3月期间38例（13.1岁±2岁）；2020年4月至9月期间31例（13.4±3岁）；2020年9月至2021年3月期间30例（14.3±2岁）；2021年4月至9月期间41例患者（13.8±2岁）。在新冠疫情第一波之前、期间或之后，患者的年龄、性别、Risser分级和SRS - 22评分之间未发现具有统计学意义的差异。新冠疫情开始后患者初次就诊时的平均Cobb角显著高于疫情前（52.2°±7°和56.6°±13°对比47.8°±12°和45.2°±13°；p = 0.0001）。在评估的五个时期内，更多患者预约了PSF（p < 0.0000），而先前接受支具治疗的患者中VBT或手术的指征逐渐减少。
在新冠疫情第一波之后首次到脊柱侧弯诊所就诊的患者Cobb角明显更大，这可能导致PSF比例增加，因为由于咨询延迟错过了支具治疗或VBT的潜在时机。
