EFFECT OF POSTOPERATIVE SHOULDER IMBALANCE ON PATIENT SATISFACTION WITH SURGICAL TREATMENT OF ADOLESCENT IDIOPATHIC SCOLIOSIS

Amaç: Bu çalışmada skolyoz cerrahisi sonrası oluşan omuz dengesizliğinin düzeyi ile hastaların tedaviden memnuniyeti arasında bir ilişki olup olmadığını değerlendirmeyi amaçladık. Materyal-Metod: Bu retrospektif klinik çalışmaya, posterior enstrümentasyon ve füzyon ile tedavi edilen ve cerrahi sonrası ortalama 35.4 ay (aralık, 24-67 ay) izlenen 23 adölesan idiyopatik skolyoz hastası (18 kadın, 5 erkek; ortalama yaş, 15.9 yıl; yaş aralığı, 13-24 yıl) dahil edildi. Koronal düzlemde omuz dengesini değerlendirmek için, posoperatif radyografide üç parametre ölçüldü: ilk kaburga açısı, radyografik omuz yüksekliği ve klavikula açısı. Hastaların skolyoz cerrahisinden memnuniyetlerini değerlendirmek için, Skolyoz Araştırma Derneği (SRS)-22r Hasta Anketi kullanıldı.Bulgular: Tüm hastalarda füzyon sağlanmıştr. Radyografide ortalama ilk kaburga açısı 2.5º±2.8º, omuz yüksekliği 6.0±5.4 mm ve klavikula açısı 1.7º±1.5º ölçülmüştür. Ortalama SRS-22r domain skorları 3.3 ile 3.8, arasında değişirken, en düşük skor mental sağlık, en yüksek skor ise ağrı ve kendi imaj/görüşü için kaydedilmiştir. Radyografik parametreler ile SRS-22r toplam ve domain skorları arasında anlamlı korelasyon bulunamamıştır.Sonuç: Adölesan idiyopatik skolyozda cerrahisinde torasik eğriliğin düzeltilmesinin sıkça rastlanan istenmeyen etkisi omuz dengesizliğidir. Ancak bu dengesizlik şiddetli olmadığı sürece, hastalarda tedaviden memnuniyetsizliğe neden olmaz.

ADÖLESAN İDİYOPATİK SKOLYOZDA CERRAHİ SONRASI OMUZ DENGESİZLİĞİNİN HASTANIN TEDAVİDEN MEMNUNİYETİ ÜZERİNE ETKİSİ

Objective: We aimed to evaluate whether there is a relation between the level of shoulder imbalance after scoliosis surgery and patients' satisfaction with treatment.Materials and methods: Twenty-three patients with adolescent idiopathic scoliosis (18 females, 5 males; mean age, 15.9 years; age range, 13-24 years), who were treated by posterior instrumentation and fusion and followed up for an average of 35.4 months (range, 24-67 months) postoperatively, were included in this retrospective clinical study. In order to evaluated shoulder balance on coronal plane, three parameters were measured on postoperative radiography: first rib angle, radiographical shoulder height, and clavicle angle. For the assessment of patients' satisfaction with scoliosis surgery, Scoliosis Research Society (SRS)-22r Patient Questionnaire was used.Results: Fusion was obtained in all patients. On radiography, mean first rib angle was 2.5º±2.8º, shoulder height was 6.0±5.4 mm, and clavicle angle was 1.7º±1.5º. The mean values for SRS22r domain scores were between 3.3 and 3.8, being lowest for mental health and highest for pain and self-image. There was no significant correlation between radiographic parameters and total or domain scores of SRS-22r.Conclusions: Shoulder imbalance is a common undesirable effect of correcting thoracic curve in surgical treatment of adolescent idiopathic scoliosis. However, unless it is severe, shoulder imbalance does not cause patient dissatisfaction.

Kaynakça

1- Alanay A, Cil A, Berk H, Acaroglu RE, Yazici M, Akcali O, Kosay C, Genc Y, Surat A. Reliability and validity of adapted Turkish version of Scoliosis Research Society (SRS- 22) questionnaire. Spine 2005; 30(21): 2464-2468.

2- Asher M, Lai SM, Burton D, Manna B. The reliability and concurrent validity of the SRS-22 patient questionnaire for idiopathic scoliosis. Spine 2003; 28(1): 63-69.

3- Chang DG, Kim JH, Kim SS, Lim DJ, Ha KY, Suk SI. How to improve shoulder balance in the surgical correction of double thoracic adolescent idiopathic scoliosis. Spine 2014; 39(23): E1359-1367.

4- Crawford CH 3rd, Glassman SD, Bridwell KH, Berven SH, Carreon LY. The minimum clinically important difference in SRS-22R total score, appearance, activity and pain domains after surgical treatment of adult spinal deformity. Spine 2015; 40(6): 377-381.

5- Hasler CC. A brief overview of 100 years of history of surgical treatment for adolescent idiopathic scoliosis. J Child Orthop 2013; 7(1): 57-62.

6- Hong JY, Suh SW, Yang JH, Park SY, Han JH. Reliability analysis of shoulder balance measures: comparison of the 4 available methods. Spine 2013; 38(26): E1684-90.

7- Imrie M, Yaszay B, Bastrom TP, Wenger DR, Newton PO. Adolescent idiopathic scoliosis: should 100 % correction be the goal? J Pediatr Orthop 2011; 31(1 Suppl): S9-13.

8- Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013; 7(1): 3-9.

9- Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg 2001; 83-A(8): 1169-1181. 10-Luhmann SJ, Sucato DJ, Johnston CE, Richards

BS, Karol LA. radiographic assessment of shoulder position in 619 idiopathic scoliosis patients: can T1 tilt be used as an intraoperative proxy to determine postoperative shoulder balance? J Pediatr Orthop 2015 doi: 10.1097/ BPO.0000000000000519 [Epub ahead of print]

11-Matamalas A, Bagó J, D'Agata E, Pellisé F. Does patient perception of shoulder balance correlate with clinical balance? Eur Spine J 2015 doi: 10.1007/s00586- 015-3971-5 [Epub ahead of print]

12-Matsumoto M, Watanabe K, Kawakami N, Tsuji T, Uno K, Suzuki T, Ito M, Yanagida H, Minami S, Akazawa T. Postoperative shoulder imbalance in Lenke Type 1A adolescent idiopathic scoliosis and related factors. BMC Musculoskelet Disord 2014; 15: 366.

13-Namikawa T, Matsumura A, Kato M, Hayashi K, Nakamura H. Radiological assessment of shoulder balance following posterior spinal fusion for thoracic adolescent idiopathic scoliosis. Scoliosis 2015; 10(Suppl 2): S18. 14-Qiu XS, Ma WW, Li WG, Wang B, Yu Y, Zhu

ZZ, Qian BP, Zhu F, Sun X, Ng BK, Cheng JC, Qiu Y. Discrepancy between radiographic shoulder balance and cosmetic shoulder balance in adolescent idiopathic scoliosis patients with double thoracic curve. Eur Spine J 2009; 18(1): 45-51.

15-Smyrnis PN, Sekouris N, Papadopoulos G. Surgical assessment of the proximal thoracic curve in adolescent idiopathic scoliosis. Eur Spine J 2009; 18(4): 522- 530.

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