Older adult idiopathic scoliosis patients have greater improvement in self-image compared to younger adult and adolescent idiopathic scoliosis patients following posterior spinal fusion.
Taylor J Jackson, Fthimnir M Hassan, Matthew Weintraub, Omar Taha, Mehdi Elfilali, Edwin Kulubya, Erik Lewerenz, Justin L Reyes, Riley Sevensky, Josephine R Coury, Andrew Zhang, Michael J Strong, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke
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引用次数: 0
Abstract
Purpose: The complex relationship between spine deformity and self-image is incompletely understood. This study aims to evaluate how age affects self-image in idiopathic scoliosis.
Methods: Single-center study of adult (AdIS) and adolescent (AIS) idiopathic scoliosis patients treated with posterior spinal fusion (PSF). Preoperative and two-year postoperative patient-reported, radiographic, and perioperative outcomes were compared. Patients were grouped according to age, AIS (< 1 8 years), young adults (yAdIS, 18-40 years) and older adults (oAdIS, > 40 years).
Results: 176 patients were included, 54 AIS (ave. 15.8 years), 47 yAdIS (mean 25.2 years), and 74 oAdIS (mean 56.5 years). Preoperative curve magnitude was similar between groups (p = 0.0863). Postoperative, AIS and yAdIS had similar curves, but smaller than oAdIS (p = 0.0104) with similar corrections (p = 0.6476). AIS had lower EBL (p < 0.0001), shorter OR times (p < 0.0001), fewer levels (p < 0.0001) and pelvic instrumentation (p < 0.0001). AIS had greater preoperative self-image scores (3.5 vs. 3.1 vs. 2.5, p < 0.0001) with no difference seen postoperative (4.4 vs. 4.3 vs. 4.2, p = 0.1230). However, the greatest improvement was observed in oAdIS patients (p < 0.0001). Independent predictors of self-image scores varied by age and included anxiety/depression (β = - 1.057), BMI (β = 0.033), and postoperative CVA (β = - 0.021) for AIS; anxiety/depression (β = - 0.513) and curve correction (β = 0.0143) in yAdIS; and postoperative pelvic tilt (β = - 0.028, p = 0.0037) for oAdIS.
Conclusion: AIS patients had the highest preoperative self-image scores, followed by yAdIS and then oAdIS. However, the greatest improvement was observed in the older patients, despite more surgical morbidity. Mental health diagnoses were associated with worse self-image scores in AIS and yAdIS, though not oAdIS.
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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