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首页> 外文期刊>Spine >The outcome of scoliosis surgery in the severely physically handicapped child. An objective and subjective assessment.
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The outcome of scoliosis surgery in the severely physically handicapped child. An objective and subjective assessment.

机译：重度肢体残疾儿童脊柱侧弯手术的结果。客观和主观的评估。

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STUDY DESIGN: A prospective, functional assessment based on physical ability and independence in daily activities was performed of patients who had severe physical handicaps and spinal deformities and were undergoing scoliosis surgery. OBJECTIVES: To determine whether improving spinal alignment and truncal balance improved the functional abilities of handicapped patients. SUMMARY OF BACKGROUND DATA: Loss of truncal stability compromises the physical independence of children who are severely handicapped. Physiologic function also may be compromised. It is not clear whether improving truncal balance actually improves their level of independence or merely halts further deterioration. METHODS: Twenty patients with significant physical handicaps resulting from neuromuscular disorders or multiple congenital anomalies and significant spinal deformity and truncal imbalance were treated surgically to realign and stabilize their spines. Their level of physical independence was evaluated before surgery, includingtheir ability to sit, ambulate, and complete activities of daily living. Evaluation was done before surgery, 6 months after surgery, and 12 months after surgery. A subjective assessment of cosmesis also was made. RESULTS: Corrective spinal surgery resulted in a deterioration of physical ability for the first 6 months. Most patients subsequently returned to their preoperative level of function. An improvement of function exceeding their preoperative level was not seen after 12 months. The cosmetic results of surgery were excellent. CONCLUSIONS: Corrective spinal surgery in patients with severe physical handicap should be performed early to preserve function and should not be dictated solely by the severity of the curvature. Improvement in the patient's level of independence may not necessarily occur after truncal stabilization. Cosmetic results in these patients with severe disabilities were extremely gratifying to the patients and their caregivers.
机译：研究设计：对患有严重身体残疾和脊柱畸形并接受脊柱侧弯手术的患者，进行了基于身体能力和日常活动独立性的前瞻性功能评估。目的：确定改善脊柱排列和躯干平衡是否能改善残障患者的功能。背景数据的总结：失去稳定性，会严重损害残障儿童的身体独立性。生理功能也可能受到损害。尚不清楚，改善尾座平衡是否实际上会提高其独立性，还是仅仅是阻止进一步的恶化。方法：对20例因神经肌肉疾病或多发性先天性异常而导致严重身体残障，脊柱严重畸形和躯干不平衡的患者进行了手术治疗，以重新调整并稳定脊柱。在手术前评估他们的身体独立性水平，包括他们坐下，行走和完成日常生活活动的能力。在手术前，手术后6个月和手术后12个月进行评估。还对美容进行了主观评估。结果：矫正脊柱手术导致头6个月的身体能力下降。大多数患者随后恢复到术前功能水平。 12个月后未见超过术前水平的功能改善。手术的美容效果极好。结论：患有严重肢体障碍的脊柱矫正手术应尽早进行，以保持功能，而不能仅由弯曲的严重程度决定。截断稳定后不一定会提高患者的独立性。这些严重残疾患者的美容效果令患者及其护理人员极为满意。

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