Hosogane Naobumi, Takeuchi Takumi, Konishi Kazumasa, Kawano Yosuke, Takahashi Masahito, Miyamoto Azusa, Tachibana Atsuko, Kono Hitoshi
Department of Orthopedic Surgery, Kyorin University, 6-20-2 Shinkawa, Mitaka 181-8611, Tokyo, Japan.
Orthopedic Surgery, Keiyu Orthopedic Hospital, 2267-1 Akouda-cho, Tatebayashi 374-0013, Gunma, Japan.
J Clin Med. 2025 Aug 4;14(15):5482. doi: 10.3390/jcm14155482.
Correction surgery for adult spinal deformity (ASD) reduces disability but may lead to spinal stiffness. Cultural diversity may also influence how this stiffness affects daily life. We aimed to evaluate the impact of correction surgery on Japanese patients with ASD using a newly developed questionnaire and to clarify how these patients adapt to their living environment postoperatively in response to spinal stiffness. This retrospective study included 74 Japanese patients with operative ASD (mean age: 68.2 ± 7.5 years; fusion involving >5 levels) with a minimum follow-up of 1 year. Difficulties in performing various activities of daily living (ADLs) were assessed using a novel 20-item questionnaire tailored to the Oriental lifestyle. The questionnaire also evaluated lifestyle and environmental changes after surgery. Sagittal and coronal spinal parameters were measured using whole-spine radiographs, and clinical outcomes were assessed using the ODI and SRS-22 scores. Coronal and sagittal alignment significantly improved postoperatively. Although the total ADL score remained unchanged, four trunk-bending activities showed significant deterioration. The lower instrumented vertebrae level and pelvic fusion were associated with lower scores in 11 items closely related to trunk bending or the Oriental lifestyle. After surgery, 61% of patients switched from a Japanese-style mattress to a bed, and 72% swapped their low dining table for one with chairs. Both the ODI and SRS-22 scores showed significant postoperative improvements. Trunk-bending activities worsened postoperatively in Japanese patients with ASD, especially those who underwent pelvic fusion. Additionally, patients often modified their living environment after surgery to accommodate spinal stiffness.
成人脊柱畸形（ASD）矫正手术可减少残疾，但可能导致脊柱僵硬。文化多样性也可能影响这种僵硬对日常生活的影响。我们旨在使用新开发的问卷评估矫正手术对日本ASD患者的影响，并阐明这些患者如何应对脊柱僵硬，在术后适应生活环境。这项回顾性研究纳入了74例接受手术治疗的日本ASD患者（平均年龄：68.2±7.5岁；融合节段>5个），随访时间至少1年。使用一份专门针对东方生活方式设计的包含20个条目的新问卷，评估患者在进行各种日常生活活动（ADL）时的困难程度。该问卷还评估了术后的生活方式和环境变化。使用全脊柱X线片测量矢状面和冠状面脊柱参数，并使用ODI和SRS-22评分评估临床结果。术后冠状面和矢状面排列明显改善。尽管ADL总分保持不变，但四项躯干弯曲活动显示明显恶化。内固定最低椎体水平和骨盆融合与11项与躯干弯曲或东方生活方式密切相关的项目得分较低有关。术后，61%的患者从日式床垫换成了床，72%的患者把矮餐桌换成了带椅子的餐桌。ODI和SRS-22评分术后均有显著改善。在接受ASD矫正手术的日本患者中，术后躯干弯曲活动恶化，尤其是那些接受骨盆融合的患者。此外，患者术后常改变生活环境以适应脊柱僵硬。
