KMID : 1189320230170010149
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Asian Spine Journal 2023 Volume.17 No. 1 p.149 ~ p.155
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Postoperative Residual Coronal Decompensation Inhibits Self-image Improvement in Adolescent Patients with Idiopathic Scoliosis
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Shohei Higuchi
Shota Ikegami Hiroki Oba Masashi Uehara Shugo Kuraishi Takashi Takizawa Ryo Munakata Terue Hatakenaka Takayuki Kamanaka Yoshinari Miyaoka Michihiko Koseki Tetsuhiko Mimura Jun Takahashi
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Abstract
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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 ¡Ã2.0 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 (+).
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KEYWORD
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Scoliosis, Postural balance, Adolescent, Postoperative complications, Patient outcome assessment
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