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后路矫形治疗成人退行性脊柱侧凸后脊柱骨盆参数与患者生活质量的相关性。

Correlations of spinopelvic parameters with quality of life of patients with adult degenerative scoliosis after posterior correction.

机构信息

Department of Orthopedics, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China.

出版信息

Jt Dis Relat Surg. 2024 Aug 14;35(3):554-561. doi: 10.52312/jdrs.2024.891.

Abstract

OBJECTIVES

This study aimed to investigate the correlations of spinopelvic parameters with the quality of life of patients with adult degenerative scoliosis (ADS) after posterior correction, and their relationships with efficacy Patients and methods: Ninety patients (40 females, 50 males; mean age: 62.4±3.3 years; range, 47 to 73 years) with adult spinal deformity treated from March 2016 to May 2020 were retrospectively enrolled. The Scoliosis Research Society (SRS)-22 questionnaire was filled in by the patients, and the Oswestry disability index (ODI) and Visual Analog Scale (VAS) for back and lower limb pain were assessed. All the patients underwent posterior correction. Spearman's analysis was conducted for the correlations of the spinopelvic sagittal parameters with quality of life. The risk factors for efficacy were identified using the multivariate logistic regression model to construct a nomogram model for efficacy and risk prediction.

RESULTS

After the operation, significant reductions were detected in the sagittal vertical axis (SVA), pelvic tilt (PT), T1 pelvic angle (TPA), pelvic incidence minus lumbar lordosis (PI-LL), and the ODI score (p<0.05). The SVA and LL were significantly negatively correlated with all subitems on the SRS-22 questionnaire but positively correlated with VAS scores for back pain (p<0.05). Thoracic kyphosis was significantly positively correlated with self-image and mental status on the SRS-22 questionnaire (p<0.05), while TPA was negatively correlated with pain and self-image (p<0.05). The PI-LL was significantly negatively correlated with pain (p<0.05).

CONCLUSION

The SVA, LL, PT, and PI-LL were independent predictors of improvement in ODI after operation for ADS. The postoperative changes in spinopelvic parameters affected the clinical outcomes in patients with ADS.

摘要

目的

本研究旨在探讨脊柱骨盆参数与成人退行性脊柱侧凸(ADS)患者后路矫正后生活质量的相关性,以及与疗效的关系。

方法

回顾性纳入 2016 年 3 月至 2020 年 5 月收治的 90 例成人脊柱畸形患者(女性 40 例,男性 50 例;平均年龄:62.4±3.3 岁;年龄范围 47 至 73 岁)。患者填写脊柱侧凸研究协会(SRS)-22 问卷,并评估 Oswestry 功能障碍指数(ODI)和下腰痛视觉模拟评分(VAS)。所有患者均行后路矫正。采用 Spearman 分析脊柱骨盆矢状参数与生活质量的相关性。采用多因素逻辑回归模型确定疗效的危险因素,构建疗效和风险预测的列线图模型。

结果

术后,矢状垂直轴(SVA)、骨盆倾斜角(PT)、T1 骨盆角(TPA)、骨盆入射角减去腰椎前凸角(PI-LL)和 ODI 评分显著降低(p<0.05)。SVA 和 LL 与 SRS-22 问卷的所有亚项均呈显著负相关,与腰痛 VAS 评分呈显著正相关(p<0.05)。胸椎后凸角与 SRS-22 问卷的自我形象和精神状态呈显著正相关(p<0.05),TPA 与疼痛和自我形象呈显著负相关(p<0.05)。PI-LL 与疼痛呈显著负相关(p<0.05)。

结论

SVA、LL、PT 和 PI-LL 是 ADS 患者后路矫正后 ODI 改善的独立预测因素。脊柱骨盆参数术后变化影响 ADS 患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bc2/11411900/cba050e3176e/JDRS-2024-35-3-554-561-F1.jpg

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