Correlation of Upper Instrumented Vertebrae and Future Cervical Spine Surgery to Patient-reported Outcomes in Adolescent Idiopathic Scoliosis Treated With Harrington Rod Instrumentation: A Minimum 40-year Follow-up.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-08-21 DOI:10.1097/BSD.0000000000001913

Aron Sulovari, Adan M Omar, Jarren A Section, Noorullah Maqsoodi, Emmanuel N Menga, James O Sanders, Cindy X Wang, Paul T Rubery, Varun Puvanesarajah, Addisu Mesfin

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引用次数: 0

Abstract

Study design: Long-term retrospective observational study.

Objective: Assess the influence of upper instrumented vertebrae (UIV) and future cervical spine surgery on patient-reported outcomes in Adolescent Idiopathic Scoliosis (AIS) treated with Harrington rod fusion.

Summary of background data: Harrington rod has been largely replaced by pedicle screw fixation due to many considerations, including complications like pseudoarthrosis and implant failure. UIV and future spine surgery are known factors that affect patient-reported outcomes.

Methods: We identified 318 AIS patients treated with Harrington rod instrumentation and fusion between 1961 and 1978. Patient questionnaires were completed, observing: NDI, SRS-7, PROMIS physical function (PF), PROMIS depression (D), and PROMIS pain interference (PI). Statistical analysis was used to compare outcome measures based on UIV and future cervical spine surgery.

Results: In patients without cervical spine surgery, those with UIV of T5 and proximal had average NDI (P=0.14) of 10.2±11.2 and SRS-7 (P=0.73) of 22.9±3.4 compared with patients with UIV T6 and distal having NDI and SRS-7 of 14.6±11.6 and 22.8±2.6. Patients without cervical spine surgery with UIV of T5 and proximal had average PROMIS PF (P=0.17) of 45.5±2.8, PROMIS D (P=0.73) of 51.8±2.7, and PROMIS PI (P=0.43) of 53.9±1.9 compared with patients with UIV T6 and distal having PROMIS PF, D, and PI scores of 43.5±2.6, 49±3.2, and 55.6±1.9, respectively. Patients with cervical spine surgery had a mean NDI (P=0.13) of 23±1.4, SRS-7 (P=0.12) of 16, PROMIS PF (P=0.11) of 39.2±2.4, and PROMIS D (P=0.43) of 55.7±2.3 as compared with NDI of 11.9±11.5, SRS-7 of 22.8±3.1, PROMIS PF of 43.5±2.6, and PROMIS D of 49.0 ± 3.2 in patients without cervical spine surgery.

Conclusion: In long-term follow-up of AIS patients who underwent Harrington rod instrumentation, patient-reported outcomes were not associated with UIV or future cervical spine surgery; patients undergoing future cervical spine surgery did report greater pain interference.

Level of evidence: Level IV.

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哈林顿棒内固定治疗青少年特发性脊柱侧凸患者报告的结果与上固定椎体和未来颈椎手术的相关性：至少40年的随访。

研究设计：长期回顾性观察性研究。目的：评估上固定椎体（UIV）和未来颈椎手术对哈林顿棒融合治疗青少年特发性脊柱侧凸（AIS）患者报告结果的影响。背景资料总结：由于假关节和假体失败等并发症的考虑，哈林顿棒已在很大程度上被椎弓根螺钉固定所取代。静脉注射和未来的脊柱手术是影响患者报告结果的已知因素。方法：1961年至1978年间，318例AIS患者接受哈林顿棒内固定和融合术治疗。完成患者问卷调查，观察NDI、SRS-7、PROMIS生理功能（PF）、PROMIS抑郁(D)和PROMIS疼痛干扰（PI）。统计分析用于比较基于静脉注射和未来颈椎手术的结局指标。结果：未行颈椎手术的患者中，T5及近端UIV患者NDI （P=0.14）为10.2±11.2,SRS-7 （P=0.73）为22.9±3.4，T6及远端UIV患者NDI及SRS-7分别为14.6±11.6和22.8±2.6。未行颈椎手术且UIV为T5及近端患者的平均PROMIS PF （P=0.17）为45.5±2.8,PROMIS D （P=0.73）为51.8±2.7,PROMIS PI （P=0.43）为53.9±1.9，而UIV为T6及远端患者的PROMIS PF、D和PI评分分别为43.5±2.6、49±3.2和55.6±1.9。颈椎手术患者的平均NDI （P=0.13）为23±1.4,SRS-7 （P=0.12）为16，PROMIS PF （P=0.11）为39.2±2.4,PROMIS D （P=0.43）为55.7±2.3，而未做颈椎手术患者的NDI为11.9±11.5，SRS-7为22.8±3.1，PROMIS PF为43.5±2.6，PROMIS D为49.0±3.2。结论：在接受哈林顿棒置入的AIS患者的长期随访中，患者报告的结果与静脉注射或未来的颈椎手术无关；将来接受颈椎手术的患者确实报告了更大的疼痛干扰。证据等级：四级。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.