The evaluation of spinopelvic parameter and health related quality of life in degenerative patientwith kyphoscoliosis who utilized second sacral alar-iliac screw / 中华骨科杂志

ABSTRACT

Objective@#To evaluate the clinical outcome and health related quality of life in degenerative patients with kyphoscoliosis who underwent S2AI placement and identify the potential risk factors of pelvic incidence variation postoperative and at last follow-up.@*Methods@#The present study reviewed degenerative patients with kyphoscoliosis who accepted surgery utilized S2AI screw between January 2015 and January 2019. 25 patients were included in our study, 4 males and 21 females, among these patients, the mean age were 58.84±6.03 years, range from 50-68 years. All patients were conducted long fusion distal to pelvis utilizing S2AI screws. According to the variation of pelvic incidence at last follow-up, we divided patients into two subgroups 1) Group I Patients' pelvic incidence increased more than 5 degree compared with post-operation. 2) Group S Patients' pelvic incidence varied less than 5 degree compared with post-operation. 13 patient (2 male, 11 female; mean age 57.23±6.06 years) were categorized into group I, and 12 patients (2 male, 10 female; mean age 60.58±5.73 years) were categorized into group S.Cobb′s angle, lumbar lordosis(LL), regional kyphosis(RK), sagittal vertical axis(SVA), pelvic incidence(PI), pelvic tilt(PT), sacral slop(SS) were recorded at pre-operation, post-operation and last follow up. The MOS item short from the health survey(SF-36) and Oswestry disability index (ODI) were also recorded at pre-operation and last follow up.@*Results@#There was no statistical difference in gender, age, preoperative Cobb angle, SVA between two groups. In group I, pelvic incidence were decreased postoperatively and increased at the last follow-up (56.92°±14.47° vs 42.69°±14.23° vs 51.62°±14.53°, P<0.05). In group S, pelvic incidence were decreased postoperatively (46.21°±12.26° vs 37.08°±12.99°, P<0.05) and remained stable at the last follow up (37.08°±12.99° vs 37.17°±13.34°, P>0.05). Cobb angle (46.08°±20.52° vs 19.96°±12.64° vs 20.28°±12.01°), RK (32.88°±15.28° vs-12.16°±17.75° vs-11.64°±17.29°), SVA (94.61±92.59 mm vs 25.49±23.89 mm) were improved significantly after surgery and remained stable at the last follow-up. HRQoL score was improved significantly in all patients at the last follow-up compared with preoperative (SF-36 PCS 36.88±10.89 vs 67.91±10.46, P<0.05; SF-36 MCS 33.48±10.96 vs 60.19±8.10, P<0.05; ODI 46.00%±13.54% vs 23.40%±8.86%, P<0.05).@*Conclusion@#Pelvic fixation utilizing S2AI screw can provide substantial correction and patients' HRQoL can be improved significantly after surgery. Meanwhile, PI changed at the last follow-up in partial patient. The variation of PI may be associated with the preoperative sagittal malalignment.