دورية أكاديمية
Rib-on-Pelvis Deformity and Reported Pain in Neuromuscular Early-Onset Scoliosis.
| العنوان: | Rib-on-Pelvis Deformity and Reported Pain in Neuromuscular Early-Onset Scoliosis. |
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| المؤلفون: | Desai VM; Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA.; Harvard Medical School., Bowen M; Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA., Anari JB; Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA., Flynn JM; Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA., Brooks JT; Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX., Snyder B; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA., Ramo B; Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX., Li Y; Department of Orthopaedic Surgery, C. S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI., Andras LM; Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Los Angeles, CA., Truong WH; Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul, MN., Fitzgerald R; Children's Orthopaedic and Scoliosis Surgery Associates, Tampa, FL., El-Hawary R; Division of Orthopaedic Surgery, Dalhousie University, Halifax, NS, Canada., Roye B; Department of Orthopaedic Surgery, New York-Presbyterian Morgan Stanley Children's Hospital, New York., Yaszay B; Department of Orthopaedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA., Kwan KYH; Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong., McIntosh A; Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX., Nelson S; Department of Orthopaedic Surgery, University of Rochester, Rochester, NY., Gupta P; Department of Orthopaedic Surgery, Shriners Children's Chicago, Chicago, IL., Erickson M; Department of Orthopaedic Surgery, Children's Hospital Colorado, Aurora, CO., Garg S; Department of Orthopaedic Surgery, Children's Hospital Colorado, Aurora, CO., Cahill PJ; Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA. |
| مؤلفون مشاركون: | Pediatric Spine Study Group |
| المصدر: | Journal of pediatric orthopedics [J Pediatr Orthop] 2024 Jul 11. Date of Electronic Publication: 2024 Jul 11. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins Original Publication: New York Ny : Raven Press |
| مستخلص: | Background: Neuromuscular early-onset scoliosis (N-EOS) often presents with a long sweeping thoracolumbar scoliosis and pelvic obliquity. With severe pelvic obliquity, the ribs come into contact with the high side of the pelvis, termed rib-on-pelvis deformity (ROP). The goal of this study is to evaluate whether ROP is associated with reported pain and other health-related quality of life (HRQOL) measures. We hypothesize that ROP is associated with increased pain and negative HRQOL. Methods: A multicenter international registry was queried for all nonambulatory patients with N-EOS from 2012 to 2022. Both surgical and nonsurgical patients were included. ROP was classified as a binary radiographic assessment of preoperative (surgical patients) and most recent follow-up (nonsurgical patients) upright radiographs. Reported pain and other HRQOL measures were assessed through the 24-Item Early Onset Scoliosis Questionnaire (EOSQ-24). Patients with nonupright radiographs or EOSQ-24 questionnaires and corresponding radiographs >4 months apart were excluded. Results: Totally, 225 patients (8.4±3.1 y, 55% female) were included. The median major curve was 63.3 (IQR: 40.6 to 81.2) degrees and median pelvic obliquity was 15.5 degrees (IQR: 8.8 to 26.4). Eighty-three patients (37%) had ROP. ROP was associated with both frequency (P<0.001) and severity (P<0.001) of pain. ROP was associated with worse general health (P=0.01), increased difficulty with vocalization (P=0.02), increased frequency of shortness of breath (P=0.002), and increased difficulty sitting upright (P=0.04). Regarding overall EOSQ-24 domains, ROP was associated with worse general health, pain/discomfort, pulmonary function, and physical function (P<0.01). In a subanalysis of 76 patients who underwent surgical intervention with at least 2 years of follow-up, patients with preoperative ROP experienced significantly greater improvements in both frequency (P=0.004) and severity (P=0.001) of pain than the patients without preoperative ROP at 2 years postoperatively. Conclusions: The overall incidence of ROP in N-EOS is about 37%. ROP is associated with greater pain and worse HRQOL through the EOSQ-24 questionnaire. Furthermore, these patients experienced a greater reduction in pain after surgery. Clinicians and parents must be aware that ROP is possibly a pain generator, but responds positively to surgical intervention. Level of Evidence: Level III. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
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| تواريخ الأحداث: | Date Created: 20240711 Latest Revision: 20240711 |
| رمز التحديث: | 20240711 |
| DOI: | 10.1097/BPO.0000000000002768 |
| PMID: | 38987900 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1539-2570 |
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| DOI: | 10.1097/BPO.0000000000002768 |