Retrospective evaluation of the surgical treatment and rehabilitation of patients with idiopathic scoliosis using the ‘bone-on-bone’ surgical technique
Journal Title: Rehabilitacja Medyczna - Year 2015, Vol 19, Issue 2
Abstract
Introduction: The aim of this study was the retrospective evaluation of the results of the surgical treatment with the ‘bone on bone’ method, and the rehabilitation of patients for a period of 3 years after the operation.Materials and methods: The study included 102 patients (91 women, representing 89.2%; and 11 men, 10.8%) aged between 11 and 34 years, with an average age of 16 years. An analysis of the medical documentation covered a period of three years after the surgery. Further information on the patients’ daily life was obtained through a survey conducted 5-6 years after the surgery. The research results included data from hospital records collected during check-ups, which were used to obtain information about changes in the primary angular curvature of the spine, the body shape, preoperative and postoperative rehabilitation, as well as medical recommendations and complications. In addition, a survey was conducted among the patients that included the SF-36 Quality of Life questionnaire.Results: The minimum angle of curvature in the studied group, as determined by Cobb’s method was 32°, and the maximal angle was 102°. On average, the correction angle of the curvature in the primary segment amounted to 59.2% during the operation. The patients were divided into 3 groups. In the first group, the angle of curvature of the primary arc decreased during the observation period. Conversely, the second group showed a continuous increase of the angle from the surgery to the end of the observation period. The third group showed changes in the angle during each observation period. The survey was completed by 48 respondents, amounting to 47% of the study group. The most common form of home rehabilitation was posture control, in which was undertaken by 30 respondents (62.5%). After the operation, 30 of the respondents stated that their posture was average (62.5%); 12 persons considered it attractive (25%); 6 (12.5%) very attractive; and only 1 person considered it unattractive. Among the 48 people who filled in the SF-36 questionnaire, the average number of points achieved was 66. The most common complications that appeared after the operation were back pain, tingling, and nerve pain in the upper and lower limbs. The screws loosened in some patients, and in 1 case, the fusing material broke.Conclusion: 1) The anterior spinal fusion of scoliosis using the ‘bone on bone’ method allows for a quick correction, with a stiffening of the short spine; thus, mobility is maintained in the other segments. 2) Preoperative rehabilitation (through muscle stretching and breathing exercises) is important – the better the preparation, the greater the potential correction of the curvature and the faster the patient will return to independence after surgery. Patients 5-6 years after the surgery evaluated their quality of life as good. 4) Asymmetry and changes in the body shape during the postoperative period resulted from the correction of the curvature during the operation. The operation changed the functioning conditions of the musculoskeletal and joint systems. These changes were gradually compensated, and the application of corrective exercises and postural control accelerated this process. 5) In the majority of the respondents, the angle of curvature of the spine increased within three months after the surgery, after which it either stabilised or decreased. With time, the number of subjects with an increasing angle also decreased.
Authors and Affiliations
Łukasz Śliwa, Aleksandra Łuciuk, Katarzyna Ogrodzka, Anna Kokot, Daniel Zarzycki
Keywords
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