Theologis Alekos A, Collins Andrew P, Parhar Kanwar, Gupta Munish C
Department of Orthopaedic Surgery, University of California - San Francisco (UCSF), 500 Parnassus Ave, MUW 3rd Floor, San Francisco, CA, 94143, USA.
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
Spine Deform. 2025 Jan;13(1):251-260. doi: 10.1007/s43390-024-00971-3. Epub 2024 Sep 22.
To assess patients' perceptions of their abdominal wall following extensile anterolateral approaches to the thoracolumbar spine for adult spinal deformity (ASD) using validated questionnaires.
Adults who underwent anterior-posterior thoracolumbar spinal operations to the pelvis for ASD in which the anterior fusion was performed through an extensile anterolateral approach were reviewed. Three questionnaires were administered at least 1 year following surgery and included The Abdominal Core Health Quality Collaborative Survey (AHS-QC), The Patient Scar Assessment Scale (PSAS), and The Anterior Abdominal Incision Questionnaire (AAIQ).
Fifty-one patients (80.4% female, median age 65 years) were included. Average follow-up was 2.8 ± 1.7 years. Average number of anterior fusion levels was 3.5 ± 1.4. Patients achieved high satisfaction rates from surgery (74.5%). AAIQ responses included postoperative pain (33.3%), bulging (41.7%), and limitations in daily activities (18.8%) with only 15.7% experienced moderate-severe pain related to their incisions and only 6.3% seeking treatment for their scars. Post-operatively, 63.2% had a neutral or improved self-image of their torso and trunk, while only 10.2% stating it was much worse. Patients' overall opinion of their scar compared to their normal skin was very positive [average 2.75 ± 2.93 (10 = worst possible scar)]. Favorable scores were also reported for color difference, stiffness, change in thickness, and irregularity in their abdominal scar compared to normal skin.
Following extensile anterolateral approaches to the thoracolumbar spine for ASD, the majority of patients reported mild pain, mild functional limitations, good cosmesis, and high satisfaction rates with their anterior incisions based on validated questionnaires.
使用经过验证的问卷，评估成年脊柱畸形（ASD）患者在接受胸腰椎广泛前外侧入路手术后对腹壁的认知。
回顾性分析接受了针对ASD的胸腰椎前后路手术并通过广泛前外侧入路进行前路融合的成年患者。术后至少1年进行了三份问卷调查，包括腹部核心健康质量协作调查问卷（AHS-QC）、患者瘢痕评估量表（PSAS）和前腹部切口问卷（AAIQ）。
纳入51例患者（80.4%为女性，中位年龄65岁）。平均随访时间为2.8±1.7年。前路融合节段的平均数为3.5±1.4。患者对手术的满意度较高（74.5%）。AAIQ的结果包括术后疼痛（33.3%）、隆起（41.7%）和日常活动受限（18.8%），只有15.7%的患者经历了与切口相关的中度至重度疼痛，只有6.3%的患者因瘢痕寻求治疗。术后，63.2%的患者对其躯干和躯体的自我形象持中性或改善态度，而只有10.2%的患者表示自我形象明显变差。与正常皮肤相比，患者对其瘢痕的总体评价非常积极[平均2.75±2.93（10=最差瘢痕）]。与正常皮肤相比，患者腹部瘢痕在颜色差异、硬度、厚度变化和不规则性方面的评分也较好。
对于接受ASD胸腰椎广泛前外侧入路手术的患者，根据经过验证的问卷，大多数患者报告疼痛轻微、功能受限轻微、美容效果良好且对前切口满意度较高。
