Hevia Eduardo, Burgos Jesús, Sanpera Ignacio, García Vicente, de Santos Moreno María Teresa, Benlloch María, Mariscal Gonzalo, Barrios Carlos
Spine Unit, University of Navarra Clinic, Madrid, Spain.
Vithas Internacional, Madrid, Spain.
Arch Orthop Trauma Surg. 2025 Sep 2;145(1):433. doi: 10.1007/s00402-025-06051-z.
the aim of this report is to evaluate the long-term (≥ 10 years) functional outcomes and quality of life after surgery in AIS patients.
PROSPERO (CRD42023439331). Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Systematic Review (PRISMA) guidelines were followed. The PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were used. Comparative studies assessing outcomes ≥ 10 years after surgery in AIS patients and controls were included. Study quality was assessed using the MINORS criteria. The outcomes of interest were SRS-22/24 scores for pain, self-image, function, mental health, total score, and the Oswestry Disability Index (ODI). Comparisons were performed using mean difference (MD) with 95% confidence interval (CI). Heterogeneity was assessed using the I2 statistic. A fixed effects model was used if there was no evidence of heterogeneity.
Four comparative cohort studies and four case series were analyzed (n = 586). At long-term follow-up, pain (MD -0.47, 95%CI -0.64 to -0.30), self-image (MD -0.45, 95%CI -0.62 to -0.28), function (MD -0.45, 95%CI -0.83 to -0.07), and mental health (MD -0.53,95%CI -0.84 to -0.23) SRS-22 domains were significantly lower in surgically treated AIS patients than in controls. The total SRS score (MD -0.38, 95%CI -0.58 to -0.17) and ODI scores (MD 3.12, 95%CI 0.51 to 5.73) were lower in surgically treated patients. No significant differences were noted pre- and postoperatively ≥ 10 years after surgery in pain (MD -0.05,95%CI -0.32 to 0.23) and function (MD -0.05,95%CI -0.30 to 0.21), while self-image (MD -0.68,95%CI -1.02 to -0.34) and mental health (MD -0.37,95%CI -0.99 to 0.25) improved.
Ten years or more after surgery, patients with AIS had a significantly lower quality of life and higher disability than their healthy peers, based on lower SRS scores in multiple domains and higher ODI, except for self-image and mental health that improved.
本报告旨在评估青少年特发性脊柱侧弯（AIS）患者术后的长期（≥10年）功能结局和生活质量。
PROSPERO（CRD42023439331）。遵循系统评价和Meta分析以及系统评价的首选报告项目（PRISMA）指南。使用了PubMed、EMBASE、Scopus和Cochrane协作图书馆数据库。纳入评估AIS患者和对照组术后≥10年结局的比较研究。使用MINORS标准评估研究质量。感兴趣的结局是疼痛、自我形象、功能、心理健康、总分的SRS-22/24评分以及Oswestry功能障碍指数（ODI）。使用平均差（MD）和95%置信区间（CI）进行比较。使用I2统计量评估异质性。如果没有异质性证据，则使用固定效应模型。
分析了四项比较队列研究和四个病例系列（n = 586）。在长期随访中，手术治疗的AIS患者在疼痛（MD -0.47，95%CI -0.64至-0.30）、自我形象（MD -0.45，95%CI -0.62至-0.28）、功能（MD -0.45，95%CI -0.83至-0.07）和心理健康（MD -0.53，95%CI -0.84至-0.23）的SRS-22领域得分显著低于对照组。手术治疗患者的SRS总分（MD -0.38，95%CI -0.58至-0.17）和ODI评分（MD 3.12，95%CI 0.51至5.73）较低。术后≥10年，疼痛（MD -0.05，95%CI -0.32至0.23）和功能（MD -0.05，95%CI -0.30至0.21）在术前和术后无显著差异，而自我形象（MD -0.68，95%CI -1.02至-0.34）和心理健康（MD -0.37，95%CI -0.99至0.25）有所改善。
手术后十年或更长时间，基于多个领域较低的SRS评分和较高的ODI，AIS患者的生活质量明显低于健康同龄人，残疾程度更高，但自我形象和心理健康有所改善。
