| [Objectives]Adolescent idiopathic scoliosis is a kind of three-dimensional spinal deformity with abnormal curvature in coronal,sagittal and horizontal plane of the spine accompanied by vertebral rotation.It is the most common type of spinal deformity,and the occurrence of this disease brings physical and economic losses to patients,At present,most studies on the quality of life after adolescent idiopathic scoliosis surgery focus on health-related quality.However,as a disease with a higher incidence in females than males,it is necessary to pay attention to the quality of life after adolescent idiopathic scoliosis surgery in females.Therefore,the purpose of this study was to explore the factors related to quality of life after 3D orthopedic internal fixation in female adolescent idiopathic scoliosis patients.[Methods]In terms of evaluating postoperative quality of life in female patients with idiopathic scoliosis,this study introduces new indicators based on traditional health-related quality of life,and finally forms the scoliosis patients postoperative life quality evaluation system,including health related quality of life,depression,pressure of female sexual function,pregnancy and delivery details,and made a Qnaire.In terms of correlation analysis,this study investigated the influence of the selection of lowest instrumented vertebra,length of fusion segment,different Lenke classification and Cobb angle on postoperative quality of life scores in female adolescent idiopathic scoliosis.[Results](1)This study successfully enrolled 57 female patients with adolescent idiopathic scoliosis who underwent 3D orthopedic internal fixation surgery in our hospital from 2002 to 2016.All the enrolled patients are Han nationality,and the mean age at surgery of 57 patients is 15.3 0±1.86 years.The mean total score of SRS-22 Qnaire is 95.35±7.77 in 57 patients.The average score of functional status/activity ability is 22.54±2.26;The mean pain score is 23.49±1.53.The mean score of self-image is 19.75±3.38.The average score of psychological condition is 21.40±3.01.The mean score of treatment satisfaction is 8.16±1.50.The mean gross depression score of SDS is 34.53±9.17 in 57 patients.The mean depression standard score is 51.58±13.80.The mean fSDS-R score of 57 patients is 7.25±8.74.There are statistically significant differences in functional status/activity,self-image and sexual distress between groups fused to L2 or above and L3 or below(P<0.0001,P=0.0013,P=0.0314).Female AIS patients fused to L3 and below have lower functional status/mobility scores,higher self-image scores,and higher sexual distress scores than those fused to L2 and above.In single factor analysis of Qnaire,Q4、5、9、10、12、13、14、29、31、34、43、44、46、47、51、53 has statistical differences between the two groups.Eight patients with fusion to L2 or above gave birth,including 2 vaginal delivery,6 cesarean delivery,Two patients had dystocia and two patients had painless delivery.Eleven patients with fusion to L3 and below group gave birth,including 5 with vaginal delivery,6 with cesarean section.Two patients had dystocia and nine patients had painless delivery.In the fusion group L2 and above,1 has low back pain,3 has short-term postpartum low back pain,and 4 has long-term postpartum low back pain.In the fusion group at L3 and below,there are 6 patients with lumbago,6 patients with short-term postpartum lumbago,and 2 patients with long-term postpartum lumbago.The total score of the pregnancy pressure scale in the 19 patients with labor experience averages 7.68±7.27 points,and the average score of the fusion group at L2 and above(10.00±8.05 points)is higher than that of the fusion group at L3 and below(6.00±6.51 points).(3)The length of fusion segment was correlated with SRS-22 scale score and pain score of female AIS patients after 3D orthopedic internal fixation(P=0.0181,P=0.0361),parameter estimation was-1.03,-0.18,respectively.There are no significant differences in functional status/activity ability,self-image,psychological status,depression self-rating score and sexual distress scale score(P>0.05).(4)Among the 57 patients successfully enrolled,10 are Lenke-1 patients,4 are Lenke-2 patients,17 are Lenke-3 patients,4 are Lenke-4 patients,16 are Lenke-5 patients,and 6 are Lenke-6 patients.In the SRS-22 Qnaire,the average score of lenke-4 group is 80.25±7.18 points,which is significantly lower than the average score of the whole cohort(95.35±7.77 points)and other groups.In the functional status/activity domain,the average score of lenke-4 group is 18.25±2.06,which is significantly lower than the average score of the whole cohort(22.54±2.26)and other groups.In the pain field,the average score of lenke-4 group is 20.75±2.87,which was significantly lower than the average score of the whole cohort(23.49±1.53)and other groups.There are statistically significant differences in single item scores of different Lenke classification groups in Q2、5、8、12、13、18、27、28、36、42、51、52.(5)Treatment satisfaction in lumbar curvature group was correlated with Cobb angle r of main curvature,with a correlation coefficient of 0.43(P=0.0460).[Conclusions]Therefore,the selection of lowest instrumented vertebra has an impact on the quality of life of female patients with adolescent idiopathic scoliosis,with better mobility scores and poorer self-image scores at L2 and above compared with those at L3 and below.The length of fusion segment has an impact on the quality of life of the group.With the increase of fusion segment length,the SRS-22 scale score and pain score of female scoliosis patients after 3D orthopedic internal fixation decreased.Different Lenke types have an impact on the quality of life in this group,and patients with different Lenke types have differences in SRS-22 total score,functional status/activity score and pain score.Cobb angle has an impact on the quality of life in this group.Among female scoliosis patients with Lenke type 5 and 6,the higher the Cobb angle,the higher the treatment satisfaction score in SRS-22 scale. |
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