Quality of Life Improvement Following Surgery in Adolescent Spinal Deformity Patients: A Comparison Between Scheuermann Kyphosis and Adolescent Idiopathic Scoliosis*

被引：4

作者：

Toombs C. ^{[1
]}

Lonner B. ^{[2
]}

Shah S. ^{[3
]}

Samdani A. ^{[4
]}

Cahill P. ^{[5
]}

Shufflebarger H. ^{[6
]}

Yaszay B. ^{[7
]}

Sponseller P. ^{[8
]}

Newton P. ^{[7
]}

机构：

[1] New York University School of Medicine, 550 1st Avenue, New York, 10016, NY

[2] Department of Orthopaedic Surgery, Mount Sinai–Beth Israel Medical Center, 1st Avenue & E 16th St, New York, 10003, NY

[3] Department of Orthopaedic Surgery, Nemours Children's Clinic, Wilmington, DE

[4] Department of Orthopaedic Surgery, Shriners Hospitals for Children, 3551 N Broad St, Philadelphia, 19140, PA

[5] Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, 19104, PA

[6] Department of Orthopaedic Surgery, Miami Children's Hospital, 3100 SW 62nd Ave, Miami, 33155, FL

[7] Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5069, San Diego, 92123-4282, CA

[8] Department of Orthopaedic Surgery, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, 21287, MD

来源：

Spine Deformity | 2018年 / 6卷 / 6期

基金：

美国国家卫生研究院;

关键词：

Adolescent idipathic scoliosis; Health-related quality of life; Pain; Scheuermann's kyphosis; Scoliosis Research Society Questionnaire; Self-Image;

D O I：

10.1016/j.jspd.2018.04.009

中图分类号：

学科分类号：

摘要：

Study Design: Preoperative and two-year follow-up health-related quality of life (HRQOL) data were prospectively collected in 82 Scheuermann kyphosis (SK) and 995 adolescent idiopathic scoliosis (AIS) patients using the Scoliosis Research Society–22 patient questionnaire (SRS-22) outcomes instrument in a multicenter study. Visual analog scale (VAS) scores were also collected for the SK population. Objectives: This study assessed changes in HRQOL prospectively and compared them to those occurring in AIS. Summary of Background Data: There has been limited evaluation of patient-reported HRQOL changes with operative management of SK. Methods: Median SRS values for the SK and AIS cohorts were compared using a repeated measure of analysis of variance with age as a covariate and using a Mann-Whitney U nonparametric comparison. Results: Kyphosis was corrected from 73.9° to 45.8° (p <.001); the major curve in AIS was corrected from 55.5 to 20.2 (p <.001). Preoperative and magnitude of radiographic correction, kyphosis apex and body mass index in SK were not correlated with baseline or change in HRQOL. SK SRS scores improved after surgery in all domains with the greatest change (2.8–4.4) in self-image (p <.001). Changes in SRS Pain, Activity, and Self-Image domains met the minimal clinically important difference. Baseline SK and AIS scores differed significantly in the Self-Image, Mental Health and Total Score domains, with SK having worse scores (p <.001). At two years postoperatively, the greatest improvements were made in Self-Image, along with Mental Health and Total Score, and the SK group achieved greater gains (p <.001). At two years postoperatively, the SK scores improved to reach equivalent values to the AIS scores. VAS scores improved from 3.69 to 1.51, and these changes were correlated with change in the Pain, Mental Health, and Total Score SRS domains (p <.001). Conclusions: Surgery for SK in the adolescent population results in significant improvements in HRQOL, which outpace those of the AIS population. Level of Evidence: Level II. © 2018 Scoliosis Research Society

引用

页码：676 / 683

页数：7

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