Is young adult idiopathic scoliosis a distinct clinical entity from adolescent idiopathic scoliosis? a Systematic Review and Meta-analysis comparing pre-operative characteristics and operative outcomes.

IF 1.6 Q3 CLINICAL NEUROLOGY
Spine deformity Pub Date : 2024-09-01 Epub Date: 2024-05-09 DOI:10.1007/s43390-024-00892-1
Monis A Khan, Esteban Quiceno, Robert A Ravinsky, Amna Hussein, Ebtesam Abdulla, Kristin Nosova, Alexandros Moniakis, Isabel L Bauer, Annie Pico, Nikhil Dholaria, Courtney Deaver, Giovanni Barbagli, Michael Prim, Ali A Baaj
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引用次数: 0

Abstract

Purpose: This study aims to conduct a systematic review of the literature comparing pre-operative, intraoperative, and post-operative characteristics between adolescent idiopathic scoliosis (AIS) and young adult idiopathic scoliosis (YAdIS) patients.

Methods: Following PRISMA guidelines, we conducted a search of the PubMed/Medline, EMBASE, and Cochrane Central databases to identify full-text articles in the English-language literature. Our inclusion criteria were studies that compared preoperative, intraoperative, and postoperative characteristics between AIS and YAdIS patients. We performed a meta-analysis reporting mean difference (MD) for continuous variables and Odds ratios (ORs) to assess differences in postoperative complications.

Results: Seven studies consisting of 1562 patients were included in the meta-analysis. The AIS group exhibited less intraoperative bleeding and shorter surgical procedures, with a mean difference between groups of 122.3 ml (95% CI 46.2-198.4, p = 0.002) and 28.7 min (95% CI 6.5-50.8, p = 0.01), respectively. Although the preoperative Cobb angle did not differ between groups (p = 0.65), patients with AIS achieved superior postoperative deformity correction, with a mean difference of 7.3% between groups, MD - 7.3 (95% CI - 9.7, - 4.8, p < 0.00001), and lower postoperative Cobb angles of the major curve, MD 4.2 (95% CI 3.1, 5.3, p < 0.00001). YAdIS patients were fused, on average, 0.2 more vertebral levels than AIS patients, MD 0.2 (95% CI 0.01, 0.5, p = 0.04). AIS patients experienced a significantly shorter length of stay after the surgical procedure, with an MD of 0.8 days (95% CI 0.1, 1.6, p = 0.02). No significant difference was found between groups in terms of complications (p = 0.19).

Conclusions: YAdIS should be regarded as a distinct surgical entity, characterized by increased bleeding, longer surgical duration, greater deformity correction challenges, and the need for fusion of additional vertebral levels compared to AIS. Surgeons should be mindful of these differences and discuss them with patients and their families, especially in cases where the correction of the AIS deformity is delayed and there is a high risk of progression after skeletal maturity. Further research is needed to explore alternative surgical techniques and enhance outcomes for YAdIS patients.

比较术前特征和手术结果的系统综述和元分析》(Systematic Review and Meta-analysis)。
目的:本研究旨在对比较青少年特发性脊柱侧凸(AIS)和年轻成人特发性脊柱侧凸(YAdIS)患者术前、术中和术后特征的文献进行系统性回顾:按照 PRISMA 指南,我们对 PubMed/Medline、EMBASE 和 Cochrane Central 数据库进行了检索,以确定英文文献中的全文文章。我们的纳入标准是比较 AIS 和 YAdIS 患者术前、术中和术后特征的研究。我们进行了一项荟萃分析,报告了连续变量的平均差(MD)和评估术后并发症差异的比值比(ORs):荟萃分析包括 7 项研究,共 1562 名患者。AIS 组术中出血少,手术时间短,组间平均差异分别为 122.3 毫升(95% CI 46.2-198.4,p = 0.002)和 28.7 分钟(95% CI 6.5-50.8,p = 0.01)。虽然各组患者术前的 Cobb 角没有差异(p = 0.65),但 AIS 患者术后的畸形矫正效果更佳,各组之间的平均差异为 7.3%,MD - 7.3(95% CI - 9.7,- 4.8,p 结论:YAdIS 应被视为畸形矫正的一种方法:与 AIS 相比,YAdIS 的特点是出血量增加、手术时间延长、畸形矫正难度加大以及需要融合更多的椎体水平。外科医生应注意这些差异,并与患者及其家属进行讨论,尤其是在AIS畸形矫正延迟且骨骼成熟后进展风险较高的情况下。我们需要进一步开展研究,探索替代手术技术,提高 YAdIS 患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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