ORIGINAL

Comparação entre Nível Distal Instrumentado e Qualidade de Vida na Escoliose Idiopática do Adolescente

Comparison between Instrumented Distal Vertebra and Quality of Life in Adolescent Idiopathic Scoliosis

  • Allan Stéfano Vailant Garcia (1)
  • Karla Marcovich Rossoni (2)
  • Rafael Steffen (3)
  • Igor de Barcellos Zanon (4)
  • Igor Machado Cardoso (4)
  • Charbel Jacob Júnior (4)
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Resumo

Introdução: A escoliose idiopática do adolescente é definida como uma curvatura da coluna vertebral de 10 graus ou mais, calculada pelo método de Cobb, diagnosticada no adolescente e com causa desconhecida. Quando indicado o tratamento cirúrgico, a extremidade distal da instrumentação deve estar o mais proximal possível para preservar os segmentos lombares móveis e o mais distal possível para evitar a descompensação da coluna. Objetivo: Avaliar a influência da última vértebra instrumentada na qualidade de vida de pacientes submetidos a tratamento cirúrgico para escoliose idiopática do adolescente. Métodos: Estudo retrospectivo e transversal do tipo série de casos. Para a avaliação, foram correlacionadas as variáveis sexo, idade na data da cirurgia, número de vértebras instrumentadas, classificação de Lenke e última vértebra instrumentada com os domínios do questionário SRS-22r. Resultados: Foram avaliados 39 pacientes, sendo 33 (84,6%) do sexo feminino, com média de idade de 14,5 anos na data da cirurgia. Utilizando os critérios de Lenke, 30 adolescentes (76,9%) foram classificados como 3CN e os demais como 1AN. Todos foram submetidos a artrodese por via posterior e instrumentação com parafusos pediculares. As últimas vértebras instrumentadas foram D12, L1, L3 e L4. Não houve significância estatística na correlação entre as variáveis sexo e última vértebra instrumentada com a qualidade de vida. Apresentaram significância as correlações entre a variável idade na data da cirurgia e o domínio satisfação com o tratamento e a variável classificação de Lenke e o domínio dor. Conclusão: O último nível instrumentado não parece interferir na qualidade de vida.

Palavras-chave

Escoliose; Fusão vertebral; Qualidade de vida

Abstract

Introduction: Adolescent idiopathic scoliosis is defined as a spinal curvature of 10 grades or more, calculated by the Cobb method, diagnosed in adolescents and with unknown cause. When surgical treatment is indicated, the distal end of the instrumentation should be as proximal as possible to preserve the mobile lumbar segments and as distal as possible to avoid spinal decompensation. Objective: To assess the influence of the last instrumented vertebra on the quality of life of patients undergoing surgical treatment for adolescent idiopathic scoliosis. Methods: Retrospective and cross-sectional case series study. Variables of gender, age at surgery date, number of vertebrae instrumented, Lenke classification and last vertebrae instrumented were correlated with the domains of the SRS-22r questionnaire. Results: A total of 39 patients was selected, and 33 (84.6%) were female, with a mean age of 14.5 years on the date of surgery. Using Lenke’s criteria, 30 adolescents (76.9%) were classified as 3CN and the others as 1AN. All patients underwent spine arthrodesis performed posteriorly with instrumentation using pedicle screws. The last vertebrae instrumented were D12, L1, L3 and L4. There was no statistical significance in the correlation between the variables gender and last vertebrae instrumented with quality of life. The correlations between the variable age at the time of surgery and the domain of satisfaction with the treatment and the variable Lenke’s classification and the domain of pain were significant. Conclusion: The last instrumented level does not seem to interfere with quality of life.

Keywords

Scoliosis; Spinal fusion; Quality of life

References

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1 MD, MR, Orthopedist, Medical Residency at Service of Spine Surgery, Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.
2 MD, MR, Medical Residency at Orthopedics Service, Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.
3 MS, Medical student, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória – EMESCAM, Vitória, ES, Brazil.
4 MD, Orthopedist, Specialist in Spine Surgery, Assistant Physician at the Spine Group, Higher School of Sciences of the Santa Casa de Misericordia de Vitoria, Vitória, ES, Brazil.

 

Received: Nov 20, 2021
Corrected Dec 2, 2021
Accepted Dec 16, 2021

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JBNC  Brazilian Journal of Neurosurgery

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