Postoperative Residual Coronal Decompensation Inhibits Self-image Improvement in Adolescent Patients with Idiopathic Scoliosis

Higuchi Shohei; Ikegami Shota; Oba Hiroki; Uehara Masashi; Kuraishi Shugo; Takizawa Takashi; Munakata Ryo; Hatakenaka Terue; Kamanaka Takayuki; Miyaoka Yoshinari; Koseki Michihiko; Mimura Tetsuhiko; Takahashi Jun

doi:10.31616/asj.2021.0429

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자료유형: 학술저널

저자정보: Higuchi Shohei (Shinshu University School of Medicine Matsumoto Japan) Ikegami Shota (Shinshu University School of Medicine Matsumoto Japan) Oba Hiroki (Shinshu University School of Medicine Matsumoto Japan) Uehara Masashi (Shinshu University School of Medicine Matsumoto Japan) Kuraishi Shugo (Shinshu University School of Medicine Matsumoto Japan) Takizawa Takashi (Shinshu University School of Medicine Matsumoto Japan) Munakata Ryo (Shinshu University School of Medicine Matsumoto Japan) Hatakenaka Terue (Shinshu University School of Medicine Matsumoto Japan) Kamanaka Takayuki (Shinshu University School of Medicine Matsumoto Japan) Miyaoka Yoshinari (Shinshu University School of Medicine Matsumoto Japan) Koseki Michihiko (Faculty of Textile Science and Technology Shinshu University Ueda Japan) Mimura Tetsuhiko (Orthopaedic Surgery Shinshu University School of Medicine Matsumoto Japan) Takahashi Jun (Orthopaedic Surgery Shinshu University School of Medicine Matsumoto Japan)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.17 No.1

발행연도: 2023.2

수록면: 149 - 155 (7page)

DOI: 10.31616/asj.2021.0429

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Study Design: Retrospective cohort study.Purpose: This study aimed to evaluate the relationship between C7 plumb line (C7PL) decompensation and the Scoliosis Research Society (SRS) 22-item patient questionnaire scores, including those related to self-image, preoperatively and 2 years after surgery.Overview of Literature: In the surgical treatment of adolescent idiopathic scoliosis (AIS), inferior trunk balance caused by C7PL decompensation can negatively affect patients’ quality of life. However, there are few reports in the literature that describe or clarify how postoperative trunk imbalance affects each SRS-22 domain, including self-image domain scores.Methods: A total of 120 patients with AIS who underwent posterior spinal fusion from August 2006 to March 2017 at our facility and were followed up for 2 years or more were included. Radiological parameters were measured on whole-spine anteroposterior and lateral radiographs. Revised SRS-22 (SRS-22r) values were also recorded. Coronal trunk imbalance was defined as a deviation of ≥2.0 cm between the C7PL and the central sacral vertical line. Patients with and without coronal trunk imbalance at 2 years after surgery were defined as D (+) (decompensation type) and D (-), respectively. Mean SRS-22r values, including function, pain, self-image, mental health, and subtotal were compared between the D (+) and D (-) groups. Logistic regression analysis was performed to detect the preoperative factors related to D (+) using predictors, including curve type, maximum Cobb angle, and coronal trunk imbalance.Results: At 2 years after surgery, the D (+) group had a significantly lower self-image in the domain of SRS-22r scores compared with the D (-) group. Preoperative coronal trunk imbalance was significantly related to D (+) but not to significant changes in the postoperative SRS-22 score in any of the SRS-22 domains.Conclusions: Postoperative C7PL deviation lowers the self-image in patients with AIS. Patients with preoperative coronal trunk imbalance were significantly more likely to be D (+).

#Scoliosis #Postural balance #Adolescent #Postoperative complications #Patient outcome assessment

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