Spinal instrumented arthrodesis improves health-related quality of life (HRQOL), although mobility is impaired. This study evaluates activities of daily livings after thoracolumbosacroiliac arthrodesis for adult spinal deformity and patient satisfaction.
Methods
Fifty patients who underwent surgery filled self-administered questionnaires (1-year preoperative and postoperative conditions), and 36 patients (3 men and 33 women; mean age 71.4 years) participated in the study. Twenty-five activities, including weeding, snow shoveling, toilet activities, and sleeping postures, were examined. Spinal alignment with Scoliosis Research Society (SRS)—Schwab classification, HRQOL with SRS-22, complications, and patient satisfaction were evaluated. Pre- and postoperative conditions were statistically compared.
Results
Spinal alignment improved postoperatively. Comparison data revealed that strenuous activities, such as weeding and farm work, significantly deteriorated postoperatively in 42.1–87.5% patients. Other basic activities, excluding Western toilet usage, sleeping supine, laundry and kitchen chores, and changing jacket/pants, also significantly deteriorated in 21–88% patients. Only activities such as sleeping supine, standing upright, vacuuming, doing laundry, and reaching for objects placed at heights became possible with significant difference postoperatively among activities that could not be performed preoperatively. Light activities were continued, but strenuous activities were restricted. Nevertheless, the patient satisfaction rate was 70%. Six patients exhibited complications; however, none were dissatisfied with surgery outcomes. Instrumentation or proximal junctional failures were associated with at least one strenuous work activity.
Conclusions
Thoracolumbosacroiliac arthrodesis does not always improve activities postoperatively. Therefore, surgical indication for patients who continue activities preoperatively should be carefully decided.
Level of Evidence
Level 3.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.
×
Anzeige
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.
Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.
Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.
Update Orthopädie und Unfallchirurgie
Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.
