8．Evaluation of Postoperative Residual Spinal Deformity and Patient Outcome in Idiopathic Scoliosis Patients in Japan Using the Scoliosis Research Society Outcomes Instrument
日本使用脊柱侧弯研究会功能支具的病人手术后脊柱畸形的残留和特发性脊柱侧弯病人预后评价
Study Design. This study clarifies the correlation between the components of the Scoliosis Research Society Outcomes Instrument (SRS-24) and the radiographic parameters after surgery in Japanese idiopathic scoliosis patients.
text研究设计：这个研究阐明了脊柱侧弯研究会功能支具（SRS-24）组成和日本特发性脊柱侧弯病人手术后X线摄片参数的相关性。
Objectives. To investigate the correlation between the magnitude of back deformity after scoliosis surgery and the components of the SRS-24.
目的：调查研究脊柱侧凸手术后后凸畸形大小和SRS－24组成之间的相互联系。
Summary of Background Data. Patient outcomes for Japanese scoliosis patients using the SRS-24 have not been fully investigated.
背景摘要：日本脊柱侧凸病人使用SRS-24的预后没有被完全调查到。
Methods. Idiopathic scoliosis patients (n＝81) who were treated with surgery and followed up for more than 2 years were evaluated. Radiographic examination included Cobb angle, rotation angle of apical vertebrae, and translation of the C7 vertebra from the center sacral line on the coronal plane. In addition, the score of one new question regarding postoperative scar was investigated and compared with that of the individual SRS-24 domains.
方法：手术后并随访2年以上的特发性脊柱侧弯的病人（81例）被用来评价。X线检查包括Cobb角，椎体顶点的旋转角和C7椎体在冠状面从骶正中线的平移。另外，研究关于术后斑痕这一个新问题的得分和比较术后斑痕个体SRS-24区域。
Results. A comparison of the SRS-24 and radiographic results revealed a significant inverse correlation between total pain and the postoperative correction of the rotation angle in the thoracic curve (rs＝0.27; P ＜0.05). General self-image was inversely correlated with the Cobb angle (rs=－0.23; P＜0.05) and the rotation angle (rs=－0.30; P＜0.01) in the thoracic curve. Self-image after surgery was positively correlated with the correction degree of the thoracic Cobb angle (rs=0.27; P＜0.05); 60% of patients had some concerns regarding postoperative scar, and the concerned patients demonstrated significantly lower scores in the pain and general self-image domains (P＜0.05) than the unconcerned patients did.
结果：SRS-24和X线结果对照显示全身疼痛和术后胸曲旋转角矫正呈现显著负相关(rs＝0.27; P ＜0.05). 胸曲大体自我感觉和Cobb角(rs=－0.23; P＜0.05)、旋转角度(rs=－0.30; P＜0.01)呈负相关。手术后自我感觉和胸Cobb角矫正角度呈正相关(rs=0.27; P＜0.05)。60%的病人有一些担心术后瘢痕，并且在和没顾虑的病人比较，有顾虑的病人在疼痛和大体自我感觉中得到特别低的得分。
Conclusion. Patients with a greater Cobb angle or rotation angle in the thoracic curve had a negative self-image. Self-image improved after surgery by greater correction of the thoracic Cobb angle. Thoracic scoliotic deformity with prominence should be substantially reduced by the surgical treatment to improve satisfaction rates and self-image regarding back appearance. Additionally, physicians should pay more attention to patients’ concern regarding their postoperative scars to obtain better outcomes.
结论：在胸廓曲线中有更大Cobb角或旋转角的病人有一个不良的自我感觉。手术后自我感觉改善通过胸椎Cobb角更大的矫正。胸脊柱侧凸隆凸畸形经过手术治疗后实质上大大减少了，提高了满意率和关于背部外形的自我感觉。另外，医生需要更加关注病人关于手术后斑痕的忧虑以获得更好的预后。
Key words: Japanese idiopathic scoliosis patients, postoperative patient outcome, postoperative spinal deformity, Scoliosis Research Society Outcomes Instrument.
关键词：日本特发性脊柱侧凸病人，术后病人预后，术后脊柱畸形，脊柱侧凸研究协会预后支具
