摘要
目的探讨术前病程对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)矫形手术及患者术后生存质量的影响。方法行单纯后路矫形、全椎弓根内固定的AIS患者,根据术前病程分为2组:S组(术前病程<2年)和L组(术前病程≥2年)。两组患者以性别比相同、Lenke分型相同、主弯Cobb角相似进行匹配,每组均有55例入选。将两组患者术前、术后及随访时的各种放射学参数进行对比,比较两组融合椎体数、术中失血量、SRS-22量表得分等指标。结果两组患者术前主侧凸Cobb角相似,S组主侧凸柔韧性大于L组(P=0.034)。S组术前次侧凸Cobb角小于L组(P=0.035)。术后两组冠状面及矢状面放射学参数相似,术中失血及输血量无统计学差异。L组融合椎体数多于S组(P=0.027)。随访时两组SRS-22量表中功能/活动度、疼痛、自我形象/外观及精神健康得分无统计学差异,S组治疗满意度维度得分高于L组(P=0.037)。结论脊柱侧凸的柔韧性会随着病程延长而降低,病程可能是次侧凸进展的危险因素,对AIS患者术后生存质量存在影响。
Objective To study the influence of pre-operative disease course on the operation and post-operation quality of life of adolescents with idiopathic scoliosis （AIS）.Methods A total of 110 AIS patients who were treated with classic posterior correction,pedicle internal fixation were divided into two groups according to their disease courses （n=55）：short course group with a pre-operation course 2 years（S group）,long course group with a pre-operation course ≥2 years（L group）.The gender,Lenke type,and major curve Cobb angle were matchable between the two groups.Various radiographic measurements and indices like fusion level,intraoperative blood loss and scores of SRS-22 scale were compared between the two groups before operation,immediately,and 2 years after operation.Results The pre-operative Cobb angles of the major curve were similar between the two groups,but the flexibility of the major curve averaged （55.7±18.77）% in the S group and （48.1±18.24）% in the L group （P=0.034）.Pre-operative Cobb angles of the minor curve were larger in L group than those in S group （[30.1±12.10]° in the S group and [34.8±10.85]° in the L group,P=0.035）.The post-operative radiographic measurements and the blood loss/infusion were similar between the two groups.The number of fused vertebrae in the L group was significantly more than that in the S group （P=0.027）.The parameters in the SRS-22 scale,including function/activity,pain,self-image/appearance,and mental health were similar between the two groups during follow-up.And the L group had a significantly lower satisfaction rate of treatment compared with the S group （[4.0±0.70] vs [3.7±0.78],P=0.037）.Conclusion The flexibility of the curve in AIS decreases with the increase of disease course,and the disease course might be a risk factor for the scoliosis progression of the minor side.Patients with a disease course ≥2 years have more fused vertebrae than those with a disease course 2 years.The length of pre-operative disease course has influence on the quality of life of AIS patients after operation.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2010年第6期638-641,共4页
Academic Journal of Second Military Medical University
关键词
青少年特发性脊柱侧凸
病程
外科手术
生存质量
adolescent idiopathic scoliosis
course of disease
operative surgical procedures
quality of life
