Todderud Julia, Marks Michelle C, Sucato Daniel, Fletcher Nicholas, Newton Peter, Kelly Michael, Bachmann Keith, Parent Stefan, Miyanji Firoz, Yaszay Burt, Cahill Patrick, Larson A Noelle
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN, USA.
Washington State University College of Medicine, Spokane, WA, USA.
Spine Deform. 2025 May 9. doi: 10.1007/s43390-025-01096-x.
With this study, we aim to evaluate and compare the perioperative outcomes of PSF for girls and boys. We hypothesize that female patients will have better curve correction and lower rates of complications when compared to male patients.
This study employed a retrospective review of AIS patients who underwent PSF at 23 sites between 2011 and 2021, limited to preoperative curves between 40 and 60° and stratified based on sex assigned at birth. All patients had preoperative and 2-year follow-up and were evaluated for correction, complications, surgery metrics, and patient reported outcomes.
1714 patients were included in this study: 1381 girls, 333 boys. At time of surgery, the mean age was 15.4 ± 2 years for girls and 16.4 ± 2 years for boys. Boys were significantly taller and heavier than the girls. The preoperative curve magnitude was equivalent (major Cobb 50° in girls and boys, p = 0.799). Boys and girls had median 10 levels instrumented [IQR 2] (p = 0.012). At 2-year follow-up, girls with primary thoracic curves had better coronal curve measurements (22° ± 7 vs 23° ± 8, p = 0.002) and percent correction (56% ± 14 vs 53% ± 16, p = 0.004). For primary lumbar curves, curve measurements and percent correction were not different. SRS scores for 2-year post-operative patient reported outcomes were not different in boys and girls. 191 girls experienced complications compared to 48 boys (14% of their cohorts, p = 0.31). 67 girls and 14 boys underwent reoperation (5% vs 4%, p = 0.61).
At 2 years following spinal fusion for AIS, boys and girls with moderate curves exhibit similar postoperative curve correction and SRS scores. Complication rates had no difference by patient sex.
通过本研究，我们旨在评估和比较女孩和男孩后路脊柱融合术（PSF）的围手术期结果。我们假设与男性患者相比，女性患者将有更好的曲线矫正效果和更低的并发症发生率。
本研究对2011年至2021年间在23个地点接受PSF的青少年特发性脊柱侧弯（AIS）患者进行回顾性分析，限于术前弯曲度在40至60°之间，并根据出生时指定的性别进行分层。所有患者均有术前和2年随访，并评估矫正情况、并发症、手术指标和患者报告的结果。
本研究纳入了1714例患者：1381例女孩，333例男孩。手术时，女孩的平均年龄为15.4±2岁，男孩为16.4±2岁。男孩明显比女孩更高更重。术前弯曲度大小相当（女孩和男孩的主 Cobb角均为50°，p = 0.799）。男孩和女孩的平均固定节段数为10个[四分位间距2]（p = 0.012）。在2年随访时，患有原发性胸椎侧弯的女孩有更好的冠状面弯曲度测量结果（22°±7 vs 23°±8，p = 0.002）和矫正百分比（56%±14 vs 53%±16，p = 0.004）。对于原发性腰椎侧弯，弯曲度测量结果和矫正百分比没有差异。术后2年患者报告结果的脊柱侧凸研究学会（SRS）评分在男孩和女孩中没有差异。191例女孩发生并发症，而男孩为48例（各队列的14%，p = 0.31）。67例女孩和14例男孩接受了再次手术（5% vs 4%，p = 0.61）。
在AIS脊柱融合术后2年，中度弯曲的男孩和女孩表现出相似的术后曲线矫正效果和SRS评分。并发症发生率在不同性别患者中没有差异。
