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2013년 9월 27일 금요일

A prospective assessment of SRS-24 scores after endoscopic anterior instrumentation for scoliosis

Brief review


*Title: A prospective assessment of SRS-24 scores after endoscopic anterior instrumentation for scoliosis.

척추측만증 치료를 위한 내시경 전방 유합술 후의 SRS-24점수의 전향적 측정.

*Author: John R. Crawford, FRCS, Maree T. Izatt, BPhty, Clayton J. Adam, PhD, Robert D. Labrom, FRACS, and Geoffrey N. Askin, FRACS




STUDY DESIGN: Prospective clinical case series.


OBJECTIVE:

-To evaluate the clinical outcome of anterior endoscopic instrumention for scoliosis using the Scoliosis Research Society(SRS) -24 questionnaire.

-To examine how these scores change over a 2-year follow-up period.


SUMMARY OF BACKGROUND DATA:  
The clinical results of Anterior endoscopic instrumentation correction using a validated 

outcome measure have rarely been reported in the literature.


METHODS:
Subject number: 83 consecutive patients (74 females + 9 males)

Inclusion criteria: 
underwent endoscopic anterior instrumented fusion for scoliosis using a single rod technique. (period: 2000.04~2005.01)

Surgical technique: 
To perform anterior scoliosis instrumentation and fusion via an endoscopic approach.

Clinical outcomes evaluation: To assessed before surgery and at 3, 6, 12, 24 months after surgery using the SRS-24 questionnaire.

Radiographic evaluation: 
The major Cobb angle was measured using the cobb method at all review appointments

Statistical analysis: using SPSS software, Mann-Whitney test.


RESULTS:
Clinical outcomes evaluation:
-Evaluated clinical outcomes(using SRS-24) are listed belows.















-Changes of SRS-24 scores VS time during (preop, 3,6,12,24 months) graph

-->The graph showed that the greatest improvement in function occurred between 6 and 12 months after surgery.




Radiographic evaluation:
-Mean coronal Cobb angle: 52.6° (preop) --> 21.7° (postop)


CONCLUSIONS:  
-Endoscopic anterior instrumentation for scoliosis significantly improved pain, self-image, and function.

-The SRS-24 scores at 1 year from surgery may provide a good indicator of patient outcome in the long-term.




Key points:
Endoscopic anterior instrumentation for scoliosis significantly improved pain, self-image, and
function when assessed using the SRS-24 Outcome Instrument.

Activity level improved between 3 and 6months, whereas function from back condition and postoperative function domains improved between 6 and 12 months after surgery.


No further improvement occurred in any of the SRS-24 domains after 1 year, and these scores may provide a good indicator of patient outcome in the long-term.



+ SRS-24: Scoliosis Research Society questionnarie
(Dominique A. Rothenfluh et al. Eur Spine J (2012) 21:1590–1595)
       
(Haher TR, et al. Spine 1999;24:1435–40.)