Lenke tip-1 adolesan idiyopatik skolyozda radyografik parametreler ile hasta tarafından bildirilen sonuçlar arasındaki ilişkinin belirlenmesi

Year 2023, , 368 - 375, 01.07.2023

İlker Arık , Nihal Büker , Raziye Şavkın , Nusret Ök , Ahmet Esat Kıter

https://doi.org/10.31362/patd.1251401

Abstract

Amaç: Bu çalışma, cerrahi olarak tedavi edilen Lenke tip-1 AIS'li hastalarda sagital dizilim ve spinopelvik parametreleri incelemeyi ve radyografik sonuçlar ile vücut imajı, benlik saygısı, disabilite ve anksiyete arasındaki ilişkiyi belirlemeyi amaçlamaktadır.
Gereç ve yöntem: Posterior spinal füzyon cerrahisi uygulanan ve 1 yıldan fazla takip edilen 25 hasta (ortalama yaş 14,20±1,63 yıl) retrospektif olarak değerlendirildi. A/P ve tam lateral omurga ayakta radyografilerin radyografik analizi Surgimap yazılımı ile yapıldı. Hasta tarafından bildirilen sonuçlar Walter Reed Görsel Değerlendirme Skalası, Rosenberg Benlik Saygısı Ölçeği, Oswestry Disabilite İndeksi ve Beck Anksiyete Envanteri ile değerlendirildi. Deformite ölçümleri ile hasta tarafından bildirilen sonuçlar arasındaki korelasyonlar Pearson korelasyon testi ile incelendi.
Bulgular: Erken postoperatif ve son takip değerlendirmelerinde Cobb açısı, AVT, gövde kayması, T1 tilt ve pelvik insidansta ameliyat öncesi ölçüme göre anlamlı azalma vardı (p<0,005). Oswestry disabilite indeksi, majör eğri Cobb açısı ile orta derecede negatif korelasyon (r=-0,545, p=0,007), pelvik tilt ile orta derecede pozitif korelasyon gösterdi (r=0,478, p=0,021). Diğer tüm radyografik ve hasta tarafından bildirilen sonuçlar arasında anlamlı bir ilişki yoktu (p>0,05).
Sonuç: Hasta tarafından bildirilen sonuçlar, skolyoza bağlı deformitenin fiziksel ve psikososyal etkilerinin hasta açısından değerlendirilmesi için önemlidir. Ancak, radyografik değerlendirme ile hasta tarafından bildirilen sonuçlar arasında düşük korelasyon bulundu veya hiç korelasyon bulunmadı. Bu sonuç, objektif ve hasta tarafından bildirilen sonuçların ayrı ayrı yorumlanması gerektiğini göstermektedir.

Keywords

Skolyoz, hasta tarafından raporlanan sonuç ölçütleri, cerrahi

Project Number

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Determination of the relationship between radiographic parameters and patient-reported outcomes in Lenke type-1 adolescent idiopathic scoliosis

Abstract

Purpose: This study aims to examine sagittal alignment and spinopelvic parameters in patients with surgically treated Lenke type-1 AIS and to determine the relationship between radiographic outcomes and body image, self-esteem, disability and anxiety.
Materials and methods: Twenty-five patients who underwent posterior spinal fusion surgery and followed up for more than 1 years were eveluated (mean age 14.20±1.63 years). Radiographic analysis of A/P and lateral full spine standing radiographs was carried out with the Surgimap software. The patient-reported outcomes were evaluated with Walter Reed Visual Assessment Scale, Rosenberg Self-Esteem Scale, Oswestry Disability Index and Beck Anxiety Inventory. Correlations between deformity measures and patient-reported outcomes were evaluated by the Pearson’s correlation test.
Results: There was a significant decrease in Cobb angle, AVT, trunk shift, T1 tilt and pelvic incidence at early postoperative and final follow up compared with the preoperative measurement (p<0.005). Oswestry disability index was moderately negatively correlated with major curve Cobb angle (r=-0.545, p=0.007), and moderately positively correlated with pelvic tilt (r=0.478, p=0.021). There was no significant correlation between all other radiographic and patient reported outcomes (p>0.05).
Conclusion: Patient-reported outcomes are important in terms of evaluating the physical and psychosocial effects of scoliosis-related deformity from the patient's perspective. However, low or no correlation was found between radiographic evaluation and patient-reported outcomes. This result indicates that objective and patient-reported results should be interpreted separately.

Keywords

Scoliosis, patient reported outcome measures, surgery

Supporting Institution

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Project Number

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Thanks

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References

• 1. Mak T, Cheung PWH, Zhang T, Cheung JPY. Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis. BMC Musculoskelet Disord 2021;22:44. https://doi.org/10.1186/s12891-020-03937-4
• 2. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013;7:3-9. https://doi.org/10.1007/s11832-012-0457-4
• 3. Xu XM, Wang F, Zhou XY, et al. Sagittal balance in adolescent idiopathic scoliosis: a radiographic study of spinopelvic compensation after selective posterior fusion of thoracolumbar/lumbar (Lenke 5C) Curves. Medicine (Baltimore) 2015;94:e1995. https://doi.org/10.1097/MD.0000000000001995
• 4. Clément JL, Geoffray A, Yagoubi F, et al. Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis. Eur Spine J 2013;22:2414-2420. https://doi.org/10.1007/s00586-013-2852-z
• 5. Fernandes P, Soares Do Brito J, Flores I, Monteiro J. Impact of surgery on the quality of life of adolescent idiopathic scoliosis. Iowa Orthop J 2019;39:66-72.
• 6. Han J, Xu Q, Yang Y, Yao Z, Zhang C. Evaluation of quality of life and risk factors affecting quality of life in adolescent idiopathic scoliosis. Intractable Rare Dis Res 2015;4:12-16. https://doi.org/10.5582/irdr.2014.01032
• 7. Auerbach JD, Lonner BS, Crerand CE, et al. Body image in patients with adolescent idiopathic scoliosis: validation of the Body Image Disturbance Questionnaire--Scoliosis Version. J Bone Joint Surg Am 2014;96:e61. https://doi.org/10.2106/JBJS.L.00867
• 8. Belli G, Toselli S, Latessa PM, Mauro M. Evaluation of self-perceived body image in adolescents with mild idiopathic scoliosis. Eur J Investig Health Psychol Educ 2022;12:319-333. https://doi.org/10.3390/ejihpe12030023
• 9. Çolak TK, Akgül T, Çolak I, Dereli EE, Chodza M, Dikici F. Health related quality of life and perception of deformity in patients with adolescent idiopathic scoliosis. J Back Musculoskelet Rehabil 2017;30:597-602. https://doi.org/10.3233/BMR-160564
• 10. Sharma S, Bünger CE, Andersen T, Sun H, Wu C, Hansen ES. Do postoperative radiographically verified technical success, improved cosmesis, and trunk shift corroborate with patient-reported outcomes in Lenke 1C adolescent idiopathic scoliosis? Eur Spine J 2015;24:1462-1472. https://doi.org/10.1007/s00586-014-3688-x
• 11. Pineda S, Bago J, Gilperez C, Climent JM. Validity of the Walter Reed Visual Assessment Scale to measure subjective perception of spine deformity in patients with idiopathic scoliosis. Scoliosis 2006;1:18. https://doi.org/10.1186/1748-7161-1-18
• 12. Wilson PL, Newton PO, Wenger DR, Haher T, Merola A, Lenke L, et al. A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument. Spine (Phila Pa 1976) 2002;27:2036-2040. https://doi.org/10.1097/00007632-200209150-00013
• 13. Płaszewski M, Cieśliński I, Nowobilski R, Kotwicki T, Terech J, Furgał M. Mental health of adults treated in adolescence with scoliosis-specific exercise program or observed for idiopathic scoliosis. ScientificWorldJournal 2014;2014:932827. https://doi.org/10.1155/2014/932827
• 14. Carreon LY, Sanders JO, Diab M, Sucato DJ, Sturm PF, Glassman SD, the Spinal Deformity Study Group. The minimum clinically important difference in Scoliosis Research Society-22 Appearance, Activity, And Pain domains after surgical correction of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2010;35:2079-2083. https://doi.org/10.1097/BRS.0b013e3181c61fd7
• 15. Ding R, Liang J, Qiu G, Shen J, Li Z. Evaluation of quality of life in adolescent idiopathic scoliosis with different distal fusion level: a comparison of L3 versus L4. J Spinal Disord Tech 2014;27:155-161. https://doi.org/10.1097/BSD.0000000000000073
• 16. Çolak İ, Çolak TK. A study of the reliability and validity of the Turkish version of the Walter Reed Visual Assessment Scale in adolescents with idiopathic scoliosis. J Turk Spinal Surg 2020;31:125-129.
• 17. Cuhadaroglu O. Self-esteem in Adolescents. PhD, Hacettepe University Medical Faculty, Department for Psychiatry, Ankara, Türkiye, 1986.
• 18. Yakut E, Düger T, Oksüz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976) 2004;29:581-585. https://doi.org/10.1097/01.brs.0000113869.13209.03
• 19. Ulusoy M, Sahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J. Cogn. Psychother 1998;12:163-172.
• 20. Sakti YM, Pratama BY, Cein CR, et al. Pelvic parameter improvement following deformity correction in adolescence idiopathic scoliosis: a case series. Int J Surg Case Rep 2022;92:106743. https://doi.org/10.1016/j.ijscr.2021.106743
• 21. Burton DA, Karkenny AJ, Schulz JF, Hanstein R, Gomez JA. Sagittal spinopelvic changes after posterior spinal fusion in adolescent idiopathic scoliosis. J Child Orthop 2020;14:544-553. https://doi.org/10.1302/1863-2548.14.200155
• 22. Hosseini SA, Padhy RK. Body Image Distortion. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing, Available from: https://www.ncbi.nlm.nih.gov/books/NBK546582/. Accessed May 01, 2022
• 23. Zhang J, He D, Gao J, et al. Changes in life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis with and without surgical intervention. Spine (Phila Pa 1976) 2011;36:741-745. https://doi.org/10.1097/BRS.0b013e3181e0f034
• 24. Bertuccelli M, Cantele F, Masiero S. Body image and body schema in adolescents with idiopathic scoliosis: a scoping review. Adolescent Res Rev 2023;8:97-115. https://doi.org/10.1007/s40894-022-00187-4
• 25. Mens RH, Bisseling P, de Kleuver M, van Hooff ML. Relevant impact of surgery on quality of life for adolescent idiopathic scoliosis: a registry-based two-year follow-up cohort study. Bone Joint J 2022;104:265-273. https://doi.org/10.1302/0301-620X.104B2.BJJ-2021-1179.R1
• 26. Rodrigues LMR, Gotfryd AO, Machado AN, Defino M, Asano LYJ. Adolescent idiopathic scoliosis: surgical treatment and quality of life. Acta Ortop Bras 2017;25:85-89. https://doi.org/10.1590/1413-785220172503157788
• 27. Bas T, Franco N, Bas P, Bas JL. Pain and disability following fusion for idiopathic adolescent scoliosis: prevalence and associated factors. Evid Based Spine Care J 2012;3:17-24. https://doi.org/10.1055/s-0031-1298614
• 28. Bago J, Climent JM, Pineda S, Gilperez C. Further evaluation of the Walter Reed Visual Assessment Scale: correlation with curve pattern and radiological deformity. Scoliosis 2007;2:12. https://doi.org/10.1186/1748-7161-2-12
• 29. Cheshire J, Gardner A, Berryman F, Pynsent P. Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis? Scoliosis Spinal Disord 2017;12:37. https://doi.org/10.1186/s13013-017-0144-9
• 30. D'Andrea LP, Betz RR, Lenke LG, et al. Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis? Spine (Phila Pa 1976) 2000;25:1795-1802. https://doi.org/10.1097/00007632-200007150-00010
• 31. Li J, Tseng C, Yuan Y, et al. Determining the association between the radiographic parameters and the SRS-22 scores in Chinese female patients with adolescent idiopathic scoliosis: does curve pattern matter? Br J Neurosurg 2021;1-7. https://doi.org/10.1080/02688697.2021.1875396