Improvement of spinal alignment and quality of life after corrective surgery for spinal kyphosis in patients with osteoporosis: a comparative study with non-operated patients
Improvement of spinal alignment and quality of life after corrective surgery for spinal kyphosis in patients with osteoporosis: a comparative study with non-operated patients
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DOI：
10.1007/s00198-015-3163-5
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发表时间：
2015-11-01
影响因子：
4
通讯作者：
Shimada, Y.
中科院分区：
文献类型：
--
作者：
Miyakoshi, N.;Hongo, M.;Shimada, Y.
本研究评估了绝经后骨质疏松和脊柱后凸患者在脊柱矫正手术后脊柱排列和生活质量（QOL）的变化。脊柱的全球对准和生活质量显着改善后，矫正脊柱手术，但没有达到非操作controls.Introduction的水平随着社会老龄化的加剧，脊柱后凸矫正脊柱内固定的需求正在增加，在pneumotic患者。然而，以前的研究并没有关注骨质疏松症患者脊柱矫正手术后与非手术对照患者相比生活质量（QOL）的改善。因此，本研究的目的是评估骨质疏松和脊柱后凸患者矫正脊柱内固定后脊柱对线和生活质量的变化，并将这些结果与非手术患者进行比较。方法研究对象包括39例年龄≥ 50岁的绝经后骨质疏松症患者，这些患者接受了多节段后路腰椎椎体间融合术（PLIF）治疗症状性胸腰椎或腰椎后凸畸形的脊柱矫正手术，以及82例年龄匹配的绝经后骨质疏松症患者，这些患者没有普遍的椎体骨折。采用日本骨质疏松症生活质量问卷（JOQOL）、SF-36和Roland-Morris功能障碍问卷（RDQ）评价患者生活质量。术后6个月，使用所有三份问卷评价的QOL也显著改善，尤其是疼痛和一般/心理健康的领域和子量表评分。然而，这些放射学参数，总JOQOL评分，SF-36物理成分的总结评分，和RDQ评分显着劣于non-operated controls.Conclusions的结果表明，脊柱的整体对准和生活质量显着改善后，矫正脊柱手术使用多节段PLIF骨质疏松症和脊柱后凸畸形的患者，但没有达到非手术对照组的水平。
This study evaluated changes in spinal alignment and quality of life (QOL) after corrective spinal surgery for patients with postmenopausal osteoporosis and spinal kyphosis. Spinal global alignment and QOL were significantly improved after corrective spinal surgery but did not reach the level of non-operated controls.Introduction With the increased aging of society, the demand for corrective spinal instrumentation for spinal kyphosis in osteoporotic patients is increasing. However, previous studies have not focused on the improvement of quality of life (QOL) after corrective spinal surgery in patients with osteoporosis, compared to non-operated control patients. The purposes of this study were thus to evaluate changes in spinal alignment and QOL after corrective spinal instrumentation for patients with osteoporosis and spinal kyphosis and to compare these results with non-operated patients. Methods Participants comprised 39 patients with postmenopausal osteoporosis >= 50 years old who underwent corrective spinal surgery using multilevel posterior lumbar interbody fusion (PLIF) for symptomatic thoracolumbar or lumbar kyphosis, and 82 age-matched patients with postmenopausal osteoporosis without prevalent vertebral fractures. Spinopelvic parameters were evaluated with standing lateral spine radiography, and QOL was evaluated with the Japanese Osteoporosis QOL Questionnaire (JOQOL), SF-36, and Roland-Morris Disability Questionnaire (RDQ).Results Lumbar kyphosis angle, sagittal vertical axis, and pelvic tilt were significantly improved postoperatively. QOL evaluated with all three questionnaires also significantly improved after 6 months postoperatively, particularly in domain and subscale scores for pain and general/mental health. However, these radiographic parameters, total JOQOL score, SF-36 physical component summary score, and RDQ score were significantly inferior compared with non-operated controls.Conclusions The results indicate that spinal global alignment and QOL were significantly improved after corrective spinal surgery using multilevel PLIF for patients with osteoporosis and spinal kyphosis but did not reach the level of non-operated controls.