背景:由于三维脊柱异常,成人脊柱畸形(ASD)显著影响生活质量。患者报告结果测量(PROM),例如患者报告结果测量信息系统(PROMIS-29),在评估术后结果方面发挥着至关重要的作用。这项研究旨在调查接受长段胸腰椎融合治疗ASD的患者在36个月内PROMIS-29评分的趋势,并提供对其长期效用的见解。
方法:对163例接受长段胸腰椎融合术的ASD患者进行回顾性研究。在基线和术后(0-)收集PROMIS-29评分,3-,6-,12-,18-,24-,30-,和36个月的随访。进行统计分析以评估相对于基线和连续记录的显著得分变化。
结果:在36个月时观察到所有PROMIS-29类别的显着改善,疼痛强度变化最大(-35.19%,p<0.001),物理功能(+29.13%,p<0.001),和疼痛干扰(-28.8%,p<0.001)。在0和3个月之间,最大的显著变化记录在疼痛强度(-26.5%,p<0.001),物理功能(+24.3%,p<0.001),和焦虑(-16.9%,p<0.018)。然而,成绩在3个月后趋于稳定,零类别显示与后续连续记录的显著变化。
结论:PROMIS-29评分在ASD患者中表现出显著改善,特别是在疼痛强度方面,疼痛干扰,和身体功能。然而,分数稳定超过3个月,表明PROMIS-29对长期患者康复中细微变化的敏感性有限。在ASD手术中探索PROM的最佳组合以进行全面的短期和长期结果评估的未来研究将是有益的。
Adult spinal deformity (ASD) significantly impacts the quality of life due to three-dimensional spinal abnormalities. Patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System (PROMIS-29), play a crucial role in assessing postoperative outcomes. This
study aims to investigate trends in PROMIS-29 scores over 36 months in patients undergoing long-segment thoracolumbar fusion for ASD and provide insights into its long-term utility.
A retrospective
study including 163 ASD patients undergoing long-segment thoracolumbar fusion was conducted. PROMIS-29 scores were collected at baseline and at postoperative (0-), 3-, 6-, 12-, 18-, 24-, 30-, and 36-month follow-ups. Statistical analyses was performed to assess significant score changes from baseline and in consecutive recordings.
Significant improvements in all PROMIS-29 categories were observed at 36 months, with the greatest changes in pain intensity (-35.19%, P < 0.001), physical function (+29.13%, P < 0.001), and pain interference (-28.8%, P < 0.001). Between the 0 and 3 month mark, the greatest significant changes were recorded in pain intensity (-26.5%, P < 0.001), physical function (+24.3%, P < 0.001), and anxiety (-16.9%, P < 0.018). However, scores plateaued after the 3-month mark, with zero categories showing significant changes with subsequent consecutive recordings.
PROMIS-29 scores demonstrated notable improvements in ASD patients particularly in pain intensity, pain interference, and physical function. However, scores plateaued beyond the 3-month mark, suggesting PROMIS-29\'s limited sensitivity to nuanced changes in long-term patient recovery. Future investigations exploring optimal combinations of patient reported outcome measures for comprehensive short- and long-term outcome assessments in ASD surgery would be beneficial.