COVID-19 significantly impacted initial consultation for idiopathic scoliosis.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2024-11-01 Epub Date: 2024-06-27 DOI:10.1007/s43390-024-00902-2

Matias Pereira-Duarte, Julie Joncas, Hubert Labelle, Olivier Chémaly, Félix Brassard, Jean-Marc Mac-Thiong, Soraya Barchi, Stefan Parent

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引用次数: 0

Abstract

Introduction: Since the outbreak of the COVID-19 pandemic, reduction of social activities and rapid adoption of telemedicine, decreasing face-to-face encounters seems to have negatively affected the timely Idiopathic Scoliosis (IS) referral with a spine specialist. We aim to document the progression of IS curves during COVID-19 pandemic reflected by the late presentation of patients at the initial visit with higher Cobb angles and to evaluate its influence on health-related quality of life scores.

Materials and methods: All IS patients scheduled for surgery between April 2019 and September 2021 were recruited in a prospective cohort study. The patients were divided into five cohorts of 6 month duration each according to their booking date: 2 periods before the 1st COVID-19 wave, one period during and two periods afterwards. In each cohort, patients were divided into 3: those who were scheduled for posterior spinal fusion (PSF) at 1st visit, those booked for vertebral body tethering (VBT) at 1st visit, and those scheduled for surgery but who have failed brace treatment. Variables included age, gender, Risser grade and preoperative SRS-22 scores. Chi² and ANOVA tests were used for comparison.

Results: 173 patients were analyzed. 33 patients (13.1 ± 3 y.o.) were scheduled between Apr and Sept 2019; 38 (13.1 y.o. ± 2) between Oct 2019 and Mar 2020; 31 (13.4 ± 3 y.o.) between Apr and Sept 2020; 30 (14.3 ± 2 y.o.) between Sept 2020 and Mar 2021; and 41 patients (13.8 ± 2 y.o.) between Apr and Sept 2021. Non-statistically significant differences were found between periods before, during or after the COVID-19 first wave regarding patients' age, gender, Risser grade and SRS-22 scores. Average Cobb angles of patients at their 1st visit after the beginning of the COVID-19 pandemic were significantly higher than those before COVID-19 (52.2° ± 7° and 56.6° ± 13° vs 47.8° ± 12° and 45.2° ± 13°; p = 0.0001). More patients were booked for PSF (p < 0.0000) through the five evaluated periods, while the indication of VBT or surgery in patients previously braced progressively decreased.

Conclusion: Patients presented at the scoliosis clinic for the 1st time after the 1st COVID-19 wave with significantly larger Cobb angles, and likely contributed to an increased proportion of PSF, as the potential window for bracing or VBT was missed due to a delayed consultation.

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COVID-19 对特发性脊柱侧凸的初诊有很大影响。

导言：自COVID-19大流行爆发以来，社会活动减少，远程医疗迅速普及，面对面交流减少，这似乎对脊柱专科医生及时转诊特发性脊柱侧弯症（IS）产生了负面影响。我们的目的是记录 COVID-19 大流行期间脊柱侧弯症的进展情况，反映在初诊时患者较晚出现较高的 Cobb 角，并评估其对健康相关生活质量评分的影响：在一项前瞻性队列研究中，招募了所有计划在 2019 年 4 月至 2021 年 9 月期间接受手术的 IS 患者。根据预约日期将患者分为五个队列，每个队列为期 6 个月：COVID-19 第 1 波之前两个阶段、期间一个阶段和之后两个阶段。在每个队列中，患者被分为三组：第一次就诊时计划接受脊柱后路融合术（PSF）的患者、第一次就诊时计划接受椎体拴系术（VBT）的患者，以及计划接受手术但支架治疗失败的患者。变量包括年龄、性别、Risser 分级和术前 SRS-22 评分。采用Chi2和方差分析进行比较：对 173 名患者进行了分析。33 名患者（13.1±3 岁）的手术时间安排在 2019 年 4 月至 9 月；38 名患者（13.1±2 岁）的手术时间安排在 2019 年 10 月至 2020 年 3 月；31 名患者（13.4±3 岁）的手术时间安排在 2020 年 4 月至 9 月；30 名患者（14.3±2 岁）的手术时间安排在 2020 年 9 月至 2021 年 3 月；41 名患者（13.8±2 岁）的手术时间安排在 2021 年 4 月至 9 月。在COVID-19第一波之前、期间或之后，患者的年龄、性别、Risser等级和SRS-22评分在统计学上无明显差异。COVID-19大流行开始后首次就诊患者的平均Cobb角明显高于COVID-19之前（52.2°±7°和56.6°±13° vs 47.8°±12°和45.2°±13°；P = 0.0001）。更多的患者预约了 PSF（p 结论：PSF 是一种治疗脊柱侧弯的方法：在第一次COVID-19波后首次到脊柱侧凸门诊就诊的患者，其Cobb角明显增大，这很可能是PSF比例增加的原因，因为由于就诊延迟而错过了支具或VBT的潜在窗口期。

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

Spine deformity

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.