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

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

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

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