Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society(2023)
摘要
Purpose In surgical treatment of adolescent idiopathic scoliosis (AIS), only a few studies measure both, radiological parameters and PROMs and correlate them. Methods Prospectively collected AIS-data of one scoliosis-center within a multicenter German-Spine-Society-Study. All patients underwent instrumented posterior spinal correction and fusion with pedicle-screw-dual-rod-systems from 05/2019 to 01/2021. The data were retrospectively analyzed. Inclusion criteria: age 11–17 years, follow-up (FU) at least 12 months. Clinical data, radiographic parameters, and PROMs (SRS-30-questionnaire) were collected. 100% of patients had X-ray images, 88.2% completed SRS-30. Parameters were given as mean ± SD. Differences and subdivision by lower instrumented vertebra (LIV) were analyzed by students t-test (significancy a = 0.05), associations by Pearson's correlation. Result Total of 51 patients: 15 ± 1.4 years, BMI 20.7 ± 3.7 kg/m 2 , FU 16.6 ± 6.1 months, fusion length 9.2 ± 2.3 segments, implant density 93 ± 9%, surgical time 215 ± 71 min, mean blood loss 504 ± 360 ml. Mean preoperative Cobb angle of main curve 64 ± 14°, of secondary main curve 46 ± 12°, corrected by 68 ± 11%, 56 ± 17%, respectively. Mean thoracic rib and lumbar hump significantly decreased by − 8.5 ± 7.0° and − 7.7 ± 8.9° (p < 0.5). High thoracic rib hump almost unchanged, − 0.4 ± 2.8° (p = 0.3). Thoracic kyphosis (− 0.9 ± 12.8°, p = 0.6), lumbar lordosis (1.5 ± 10.1°, p = 0.3), clavicle angle (− 0.5 ± 2.7°) and spinopelvic parameters (p > 0.5) did not significantly change, only LIV-tilt from 24.5 ± 6.7° to 6.5 ± 4.3° (p < 0.05). PROMs significantly improved (p < 0.05), no significant improvement for function/activity (p = 0.4). Preoperative mean total-score was 3.6 ± 0.5, 4.2 ± 0.3 at FU(p < 0.05). Self-image improved in 67%. Moderately strong correlation for PROMs: the better LIV-tilt (r = − 0.5) correction and the shorter surgery time (r = − 0.4), the better SRS-30 total-score. No correlation for curve correction and patient’s satisfaction. Conclusion In summary, results of this study demonstrate good surgical correction and significant improvement of most PROMs.
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关键词
Adolescent idiopathic scoliosis,Surgery,SRS-30,PROMs
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