Chuanfeng Wang

Changhai Hospital, Shanghai, Shanghai, Shanghai Shi, China

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Publications (16)29.12 Total impact

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    ABSTRACT: Osteosarcoma, which is the most common type of highly malignant bone tumor in children and adolescents, has poor diagnosis and 2-year survival rates of 15-20% following surgery or radiotherapy, and has therefore generated marked attention. In order to investigate the potential biomarkers for diagnosing osteosarcoma, the expression profiling data from normal and disease tissues were compared, respectively, and the differentially‑expressed genes were analyzed by three different statistical tests. Interacting proteins were determined and an interaction network was constructed by Search Tool for the Retrieval of Interacting Genes database. Subsequently, the protein interaction network was decomposed and Gene Otology annotation using Cytoscape, Mcode and Bingo, was conducted on the function modules. Finally, three differentially‑expressed genes GJA1, COL1A2 and COL5A2 were identified, and an interaction network was successfully generated with COL1A2 and COL5A2 at the core. From the results, it was observed that COL1A2 and COL5A2 interact with a number of genes of the matrix metalloprotease (MMP) family, including MMP1, MMP2, MMP3 and MMP14, TGFβ and RUNX2. Furthermore, these genes have been confirmed to be important in the tumorigenesis of osteosarcoma. It was hypothesized that the upregulation of the COL gene family may be considered as a diagnostic marker for osteosarcoma and collagen may be administered as a therapy.
    Molecular Medicine Reports 09/2014; · 1.17 Impact Factor
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    ABSTRACT: Osteosarcoma is the most common malignant bone-tumor with a peak manifestation during the second and third decade of life. In order to explore the influence of genetic factors on the mechanism of osteosarcoma by analyzing the inter relationship between osteosarcoma and its related genes, and then provide potential genetic references for the prevention, diagnosis and treatment of osteosarcoma, we collected osteosarcoma related gene sequences in Genebank of National Center for Biotechnology Information (NCBI) and local alignment analysis for a pair of sequences was carried out to identify the measurement association among related sequences. Then fuzzy clustering method was used for clustering analysis so as to contact the unknown genes through the consistent osteosarcoma related genes in one class. From the result of fuzzy clustering analysis, we could classify the osteosarcoma related genes into two groups and deduced that the genes clustered into one group had similar function. Based on this knowledge, we found more genes related to the pathogenesis of osteosarcoma and these genes could exert similar function as Runx2, a risk factor confirmed in osteosarcoma, this study may help better understand the genetic mechanism and provide new molecular markers and therapies for osteosarcoma.
    Pathology & Oncology Research 11/2013; · 1.56 Impact Factor
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    ABSTRACT: Transverse patella fractures are the most common type of patella fractures. Minimally invasive surgical technique for treatment of transverse patella fractures with the Cable Pin System has not been previously reported. Thirty-four patients with displaced transverse fractures of the patella were included in this prospective study and were operatively treated by the Cable Pin System with a minimally invasive technique. Postoperative evaluation was based on radiographs, Visual Analog Scale of pain, range of motion, and Bostman grading scale. A total of 31 patients were finally included, with an average follow-up period of 21 months. The average operation time was 48 minutes. Intraoperative fluoroscopy was used for 2 to 4 times (average: 2.4 times). Radiographic evidence of solid fracture union was observed in all cases in a mean period of 7.2 weeks. The Visual Analog Scale score for pain was 3.3 ± 1.4 and 1.5 ± 1.3 at 4 weeks after surgery and when radiographic fracture healing was achieved, respectively. Twenty-nine patients achieved full knee range of motion, while two patients had 10° loss of full flexion at the final follow-up visit. The average Bostman score was 29.1/30 (range, 27-30) at 1 year after surgery, and an evaluation of "excellent" was observed in 30 patients at the final follow-up visit. Surgical treatment of transverse patella fractures by the Cable Pin System with a minimally invasive technique was shown to provide satisfactory clinical results and excellent knee functions, with less pain and low incidence of complications. It could be a new option for treatment of transverse patella fractures.
    The journal of trauma and acute care surgery. 04/2012; 72(4):1056-61.
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    ABSTRACT: Cross-cultural translation and psychometric testing of the functional rating index (FRI). To evaluate the reliability and validity of the adapted simplified Chinese FRI (SC-FRI) for patients with low back pain (LBP). The FRI is a reliable and valid instrument to assess the perception of function and pain for patients with LBP. However, there is no culturally adapted, reliable, and validated FRI for use in mainland China. The translation and cross-cultural adaptation were performed following international guidelines. The SC-FRI was administered to 115 patients with LBP along with the simplified Chinese version of the Oswestry disability index, 36-item short form health survey, and the visual analogue scale. Psychometric testing included internal consistency, test-test reliability, concurrent criterion validity, and construct validity. A high completion rate of 96% and no floor or ceiling effects were noted for the SC-FRI. The internal consistency was good (i.e., Cronbach α = 0.897 for the overall SC-FRI; range, 0.851-0.890, if an item was deleted). Test-retest reliability was excellent, with an intraclass correlation coefficient of 0.948 (95% confidence interval, 0.917-0.968). Concurrent criterion validity assessment demonstrated that the SC-FRI significantly correlated with the visual analogue scale (r = 0.852, P < 0.0001) and the simplified Chinese version of the Oswestry disability index (r = 0.958, P < 0.0001). Construct validity was confirmed by the significant Pearson correlation between the SC-FRI and physical functioning (r = -0.802, P < 0.0001), Bodily Pain (r = -0.698, P < 0.0001), social functioning (r = -0.573, P < 0.0001), role-physical (r = -0.503, P < 0.0001), and general health (r = -0.502, P < 0.0001) domains of the 36-Item Short Form Health Survey. The SC-FRI showed excellent reliability and validity in the evaluation of pain and the functional health status of Chinese-speaking patients with LBP. It is simple and easy to use and can be recommended in clinical and research practice in mainland China.
    Spine 03/2012; 37(18):1602-8. · 2.16 Impact Factor
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    ABSTRACT: Comparisons of all-pedicle-screw (PS) and hybrid hook-screw (HS) instrumentation for the treatment of adolescent idiopathic scoliosis (AIS) have produced conflicting results. The aim of this study was to compare all-pedicle-screw and hybrid hook-screw instrumentation for the treatment of AIS using a matched-pair study design in which preoperative flexibility was matched. In this retrospective study conducted at one medical center, 21 all-pedicle-screw/hybrid hook-screw pairs of Lenke type I AIS patients matched for age, height, weight, body mass index, sex, and preoperative curve flexibility who had been treated at our institution from January 2000 to October 2006 were selected. Postoperative and 2-year postoperative coronal curve correction, postoperative kyphosis, blood transfusion needs, operation time, and hospital cost were measured and analyzed statistically. The PS group compared with the HS group had better postoperative correction (P = 0.0231) and 2-year coronal curve correction (P = 0.016). While statistically significant (P = 0.0073), the postoperative Cobb angle was only 3° less in the PS group, Maintenance of correction after 2 years was better in the PS group (P = 0.0016). The PS group had less blood loss (P < 0.0001) and shorter operation time (P < 0.0001), but the hospital cost for the PS group was higher (P < 0.0001). All-pedicle-screw and hybrid hook-screw instrumentations are comparable with regard to curve correction, but all-pedicle screw instrumentation reduces blood loss during surgery and shortens the operation time, which may help shorten healing time.
    Archives of Orthopaedic and Trauma Surgery 01/2012; 132(5):633-9. · 1.36 Impact Factor
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    ABSTRACT: The need for new therapeutics for Ankylosing Spondylitis (AS) is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray data accessible from the Gene Expression Omnibus database, we first identified the differentially expressed genes (DEGs) between AS samples and healthy controls, followed by the sub-pathway enrichment analysis of the DEGs. In addition, we propose the use of an approach based on targeting sub-pathways to identify potential agents for AS. A total of 3,280 genes were identified as being significantly different between patients and controls with p-values < 0.1. Our study showed that neurotrophic signaling pathway and some immune-associated pathways may be involved in the development of AS. Besides, our bioinformatics analysis revealed a total of 15 small molecules which may play a role in perturbing the development of AS. Our study proposes the use of an approach based on targeting sub-pathways to identify potential agents for AS. Candidate agents identified by our approach may provide the groundwork for a combination therapy approach for AS.
    Molecules 01/2012; 17(10):12460-8. · 2.43 Impact Factor
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    ABSTRACT: Cross-cultural adaptation and psychometric testing of the Spinal Appearance Questionnaire (SAQ). To evaluate the reliability and validity of simplified Chinese version of the SAQ (SC-SAQ). The SAQ is widely used to assess the perception of spinal appearance in patients with adolescent idiopathic scoliosis (AIS). However, there is no culturally adapted, reliable, and validated SAQ for mainland China. The cross-cultural adaptation of the original SAQ was performed following international guidelines. The SC-SAQ was administered concurrently with the simplified Chinese version of the Scoliosis Research Society-22 (SC-SRS-22) questionnaire to 223 patients with AIS. A total of 92 patients were randomly selected to complete the questionnaires again 4 to 7 days after the first completion. Psychometric testing included reliability by internal consistency and test-test reliability, convergent validity by comparing the SC-SAQ with the SC-SRS-22 appearance domain, and discriminant validity by analyzing the relationship between SC-SAQ scores and patients' characteristics. Internal consistency for the SC-SAQ was satisfactory, with intradomain correlations ranging from r = 0.526 to r = 0.808 (P, 0.0001). The test-retest reliability for the SC-SAQ was excellent with intraclass correlation coefficient of 0.933 (95% confidence interval = 0.903-0.956) and good Bland-Altman agreement. (No systematic bias was found in the Bland-Altman plot.) Convergent validity test demonstrated a moderate correlation between the overall SC-SAQ and SC-SRS-22 appearance domain, with ρ = -0.401 (P, 0.0001). Correlation between the overall SC-SAQ and the major curve magnitude was significant, with r = 0.827 (P, 0.0001). Discriminant validity was confirmed by significant differences of overall SC-SAQ and individual domain scores among the 6 subgroups categorized by the major curve magnitude (P, 0.0001) and among patients requiring exercise, bracing, or surgery (P, 0.0001). The SC-SAQ showed satisfactory reliability and validity in the evaluation of spinal deformity appearance for patients with AIS in mainland China.
    Spine 11/2011; 37(17):1497-504. · 2.16 Impact Factor
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    ABSTRACT: The objective of this retrospective study was to explore, which radiographic parameters, immediately after posterior spinal fusion with pedicle screw fixation for adolescent idiopathic scoliosis (AIS), best correlate with subjacent disc wedging at a minimum of 2-year follow-up. Sixty-four consecutive AIS patients who underwent posterior pedicle screw-only instrumentation were studied. Preoperative and postoperative radiographs were obtained to measure various parameters regarding global coronal, shoulder, sagittal, and regional balance. Specific correlation of these parameters to selected 2-year postoperative disc wedging and lowest-instrumented vertebra (LIV) tilt and translation were analyzed. The average lateral disc opening changed from 4.59±4.75 preoperatively to 1.46±2.82 at 2 weeks and 2.81±6.43 at 2 years postoperatively. Two-year postoperative lateral disc opening significantly correlated with the 2-week postoperative lateral disc opening, C7 plumbline relative to the posterior-superior corner of the first sacral vertebra distance, and LIV-center sacral vertical line (CSVL) distance (r=0.7433, P<0.0001). The two-year postoperative LIV tilt significantly correlated with the 2-week postoperative LIV tilt, T12-LIV lordosis, LIV-CSVL distance, and C7-CSVL distance (r=0.8879, P<0.0001). Two-year postoperative LIV-CSVL significantly correlated with 2-week postoperative LIV-CSVL distance and lateral disc opening (r=0.6104, P<0.0001). Two-year postoperative disc wedging, LIV tilt, and LIV translation occurred most often when disc wedging and LIV deviation or obliquity existed immediately postoperatively. This study identified a potential indicator for AIS repair. Preoperative surgical planning and intraoperative correction are important for avoiding subjacent regional imbalance after scoliosis fusion.
    Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 04/2011; 20(4):199-208. · 0.66 Impact Factor
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    ABSTRACT: A retrospective radiographic study. To investigate which preoperative radiographic parameters best correlate with the angulation and translation of the lowest instrumented vertebra (LIV) and global coronal balance after posterior spinal pedicle screw fixation for thoracolumbar/lumbar (TL/L) adolescent idiopathic scoliosis. Lenke 5C patients with a single, structural TL/L curve can be treated by either an anterior or posterior approach. One of the operative goals when treating Lenke 5C patients is to level and center the LIV, thereby achieving a better global coronal balance. To our knowledge, no study has investigated which specific radiographic parameters correlate with these surgical outcomes after posterior pedicle screw fixation. Twenty-seven patients with TL/L adolescent idiopathic scoliosis were identified in this study, and they underwent posterior fixation and fusion by pedicle screws with a minimum 2-year follow-up. Preoperative and postoperative radiographs were reviewed measuring various radiographic parameters as well as specific measurements related to the LIV. Correlation of these parameters to LIV translation and global and regional coronal balance (C7-central sacral vertical line [CSVL], LIV-CSVL distance) were then evaluated. Four patients demonstrated global coronal imbalance postoperatively by radiographic and clinical evaluation. Regression analysis identified three radiographic parameters that correlated significantly with the postoperative global coronal balance (C7-CSVL): preoperative C7-CSVL (r = 0.44, P = 0.023), preoperative LIV tilt (r = 0.60, P = 0.001), and postoperative LIV tilt (r = 0.65, P = 0.0002). The radiographic parameters that correlated with postoperative LIV-CSVL were: preoperative LIV-CSVL (r = 0.57, P = 0.017), preoperative LIV tilt (r = 0.40, P = 0.04), and postoperative LIV tilt (r = 0.46, P = 0.015). The radiographic parameters correlating to LIV translation were preoperative LIV-CSVL (r = 0.88, P < 0.001) and preoperative C7-CSVL (r = 0.44, P = 0.02). LIV tilt is a very important radiographic parameter that strongly correlates to postoperative global and regional coronal balance. In patients with Lenke 5C curves undergoing posterior spinal fixation using pedicle screw constructs, preoperative LIV tilt equal to or exceeding 25° and failure of postoperative LIV tilt to reduce below 8° correlate with a high risk of developing postoperative global coronal imbalance.
    Spine 02/2011; 36(20):1673-8. · 2.16 Impact Factor
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    ABSTRACT: This is a validation study to evaluate validity and reliability of a translated and culturally adapted Neck Pain and Disability Scale (NPAD). To conduct a cross-cultural adaptation and check the validity and reliability of a Chinese version of NPAD. Neck pain and its associated disability are very common musculoskeletal problems. NPAD is a reliable evaluation instrument for neck pain and disability, but there is no availability of a published Chinese version. NPAD was translated into Chinese. To examine the psychometric properties and clinical application of the adapted Chinese NPAD, a survey was conducted in a group of 106 patients. The factor structure of NPAD was analyzed and subscales were defined. Reliability assessment was determined by calculating internal consistency and test-retest repeatability. Validity was decided by comparing the Chinese version of SF-36 to NPAD and conducting subscales comparisons to single SF-36 domains. Factor analyses demonstrated four subscales for NPAD: "pain," "disability," "neck-specific function," and "emotional and cognitive influences." The internal consistency for "pain," "disability," "neck-specific function," and "emotional and cognitive influences" subscales was 0.935, 0.952, 0.955, and 0.910, respectively. Test-retest reliability was also acceptable for the whole scale (r = 0.813, P < 0.001), as well as for each of the four subscales. Construct validity was established through comparison with SF-36. All the subscales were significantly correlated with the SF-36 domains, except the items associated with Mental Health and Emotional Role. The authors report the validation of a Chinese version of NPAD for use in China, which is culturally relevant, reliable, repeatable, and psychometrically sound.
    Spine 02/2011; 36(20):E1322-7. · 2.16 Impact Factor
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    ABSTRACT: The aim of the prospective, comparative radiographic analysis was to determine the role of the fulcrum-bending radiograph (FBR) for the assessment of the proximal thoracic (PT), main thoracic (MT), and the thoracolumbar/lumbar (TL/L) curves in patients undergoing posterior spinal pedicle screw fixation and fusion for adolescent idiopathic scoliosis (AIS). The FBR demonstrated statistically better correction than other preoperative methods for the assessment of frontal plane correction of the MT curves. The fulcrum-bending correction index (FBCI) has been considered a superior method than the correction rate for comparing curve correction undergoing posterior spinal fusion because it accounts for the curve flexibility. However, their applicability to assess the PT and TL/L curves in AIS patients remains speculative. The relation between FBR and correction obtained by pedicle screws fixation is still unknown. Thirty-eight consecutive AIS patients who underwent pedicle screw fixation and posterior fusion were included in this study. The assessment of preoperative radiographs included standing posterior-anterior (PA), FBR, supine side-bending, and postoperative standing PA and lateral plain radiographs. The flexibility of the curve, as well as the FBCI, was calculated for all patients. Postoperatively, radiographs were assessed at immediate (i.e. 1 week), 3-month, 6-month, 12-month, and 2-year follow-up. Cobb angles were obtained from the PT, MT, and TL/L curves. The study consisted of 9 PT, 37 MT, and 12 TL/L curves, with a mean age of 15.1 years. The mean FBR flexibility of the PT, MT, and the TL/L curves was 42.6, 61.1, and 66.2%, respectively. The mean operative correction rates in the PT, MT, and TL/L curves were 43.4, 69.3, and 73.9%, respectively, and the mean FBCI was 103.8, 117.0, and 114.8%, respectively. Fulcrum-bending flexibility was positively correlated with the operative correction rate in PT, MT, and TL/L curves. Although the correction rate in MT and TL/L curves was higher than PT curves, the FBCI in PT, MT, and TL/L curves was not significantly different (p < 0.05). The FBR can be used to assist in the assessment of PT, MT, and TL/L curve corrections in AIS patients. When curve flexibility is taken into account by FBR, the ability of pedicle screws to correct PT, MT, and TL/L curves is the same.
    European Spine Journal 01/2011; 20(1):105-11. · 2.47 Impact Factor
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    ABSTRACT: In this study we intended to prove that being overweight has an unfavorable impact on the surgical treatment outcome of adult idiopathic scoliosis (AdIS). This is a retrospective study on the surgical treatment of seventy-one more than 30 years old (58 females and 13 males; mean age 42.9±12.2) idiopathic scoliotic patients with a minimum follow up of at least 2 years. The patients were divided into an overweight group (BMI≥23) and a non-overweight group (BMI<23). Preoperative, postoperative first erect and final follow-up radiographic measures, perioperative data, the Oswestry disability index (ODI), and the visual analog scale (VAS) were reviewed and compared. In the overweight group, no significant differences in radiographic measures, perioperative data, preoperative comorbidities, or postoperative complications, except for the more frequent concomitance of preoperative thoracic kyphosis 37.9±7.7 vs. 26.5±11.8 (P = 0.000) and thoracolumbar kyphosis 14.9±10.1 overweighted group vs. 6.5±9.9 non-overweighted group respectively (P = 0.002) were found. A higher morbidity of hypertension 36.8% vs. 9.6% (P = 0.004) was also observed in the overweight group. Postoperative ODI and VAS improved significantly in both groups compared to pre-operative values. The postoperative ODI of the overweight group (19.6±12.4) was significantly higher than that of the non-overweight group (12.4±7.9) (P = 0.022). Overweight adult idiopathic scoliotic patients had more frequent concomitance of preoperative thoracic kyphosis and thoracolumbar kyphosis and more serious postoperative pain. However, BMI did not affect the outcomes of surgical correction for coronal and sagittal scoliotic deformity and their postoperative complication rates were not significantly affected.
    PLoS ONE 01/2011; 6(7):e21601. · 3.53 Impact Factor
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    ABSTRACT: A retrospective correlation study. To identify radiographically if there is a correlation of the sagittal thoracolumbar alignment to the axial vertebral rotation and coronal scoliotic curvature in thoracolumbar/lumbar (TL/L) adolescent idiopathic scoliosis (AIS). The consistent positive correlation between coronal angulations and axial rotation has been defined as a typical feature of AIS. However, the correlation of sagittal alignment transformation to axial and/or coronal deformity has not been definitely described, especially for primary TL/L AIS. On standard anteroposterior and lateral radiographs of 43 patients with TL/L AIS, coronal and sagittal parameters including primary TL/L and compensatory thoracic curve, thoracic kyphosis, thoracolumbar junctional sagittal curve (TLJS), and lumbar lordosis, were evaluated using the Cobb method. Apical vertebral rotation (AVR) was evaluated using the Perdriolle torsionmeter. The correlation was investigated between all parameters. After the patients were divided into 2 subgroups according to the TLJS curvature, the average AVR and coronal TL/L Cobb were compared between the 2 groups. The average TLJS Cobb was 4.5° ± 8.8° (range, -12.5°-24.3°) with 28 cases (65.1% of all cases) in TLJS+ (kyphosis) group and 15 cases in TLJS- (lordosis) group. Significant correlations were observed between AVR and coronal TL/L curvature (P < 0.001), and between AVR and sagittal TLJS Cobb angle (P < 0.001). These correlations still existed when the partial correlation analysis was conducted. The correlation between sagittal TLJS and coronal TL/L curvature became nonsignificant (P = 0.405) when the partial correlation analysis was conducted with AVR as control variable. Besides, a significant difference of 7.0° was observed in average AVR between TLJS+ and TLJS- subgroups (P < 0.001). From the standard anteroposterior and lateral radiographs, an increased kyphosis of the thoracolumbar junction was observed in TL/L AIS, and it was demonstrated to be positively correlated to more axial vertebral rotation of the scoliotic spine.
    Spine 11/2010; 35(23):E1334-8. · 2.16 Impact Factor
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    ABSTRACT: A retrospective analysis of 150 adolescents who underwent spinal fusion for idiopathic scoliosis. To analyse the incidence of the postoperative proximal junctional kyphosis after posterior fusion to the upper thoracic vertebra in adolescents with idiopathic scoliosis and to explore its risk factors. The reported incidence of the proximal junctional kyphosis after the posterior fusion in patients with idiopathic scoliosis varies depending on surgical methods and strategies adopted by the institution. The changes in the Cobb angle of the proximal junctional kyphosis on the lateral spine X-ray were measured and the presence of PJK was recorded. The risk factors were screened using statistical analysis. PJK occurred in 35 out of 123 patients with an overall incidence of 28%. Among them, 28 patients (80%) experienced PJK within 1.5 years after surgery. The PJK-inducing factors included greater than 10 degrees intraoperative decrease in thoracic kyphosis, thoracoplasty, the use of a pedicle screw at the top vertebra, autogenous bone graft and fusion to the lower lumbar vertebra (below L2). There is a high incidence of postoperative proximal junctional kyphosis after posterior fusion to the upper thoracic vertebra within 1.5 years after surgery in adolescents with idiopathic scoliosis. In order to reduce its incidence, the risk factors for PJK should be carefully evaluated before surgery.
    Injury 04/2010; 41(4):415-20. · 1.93 Impact Factor
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    ABSTRACT: STUDY DESIGN.: A prospective cross-sectional study. OBJECTIVE.: To study the effects of living environment, rural and urban, on the postoperative quality of life in adolescent patients with idiopathic scoliosis (AIS) and to explore its causes. SUMMARY OF BACKGROUND DATA.: Many factors are capable of influencing the health-related quality of life of AIS patients including degree of the malformation, culture, treatment method, and the living environment of the patient. METHODS.: Postoperative AIS patients (n = 117, 16 males and 101 females) were divided into 2 groups (the urban group and the rural group). All patients completed the simplified Chinese version of the SRS-22 scale and the scores on the individual domain, and items were compared between the 2 groups. RESULTS.: The score on satisfaction of management domain in the urban group was higher than that in the rural group, but the score on the self-image/appearance in the urban group was significantly lower (P < 0.05). There were no significant differences in function/activity, pain or mental health domain between the 2 groups (P > 0.05). Scores for items 12, 15, and 18 in the function/activity domain, items 4, 6, and 10 in the self-image/appearance domain, and item 22 in the satisfaction of management domain were significantly different between the 2 groups (P < 0.05). CONCLUSION.: Living environment may influence the assessment results of the postoperative quality of life in AIS patients. The effects of environment (i.e., rural vs. urban) should be considered when using the SRS-22 scale to evaluate the quality of life of the patients.
    Spine 02/2010; · 2.16 Impact Factor
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    ABSTRACT: Bracing is frequently used for the treatment of adolescent idiopathic scoliosis. Such treatment is not always effective, and corrective surgery may be warranted. Brace treatment has been suggested to negatively affect quality of life. This study assessed postoperative quality of life and surgical outcome in Chinese patients with adolescent idiopathic scoliosis and failed brace treatment. Ninety-four patients with adolescent idiopathic scoliosis who underwent simple posterior corrective surgery and pedicle screw fixation were studied. The patients were divided into 2 groups: brace and surgery treatment (BS group) and surgery with no brace treatment (S group). Radiological parameters were assessed preoperatively, immediately postoperatively, and >2 years postoperatively. Postoperative quality of life was determined using the Scoliosis Research Society-22 (SRS-22) questionnaire. The preoperative minor curve Cobb angle was significantly greater in the BS group (34.9 degrees vs 29.4 degrees ; P=.037). Postoperative radiological parameters in the coronal and sagittal planes were similar. There were a significantly higher number of fused vertebrae in BS compared to S group patients (10.3 vs 9.6; P=.044). There were no significant postoperative differences between groups in function/activity, pain, mental health, or satisfaction of management as determined by the SRS-22. Self-image/appearance scores were significantly higher in BS compared to S group patients (4.0 vs 3.8; P=.010). Preoperative brace treatment may be a risk factor for minor curve progression but does not appear to significantly influence surgical outcome. Postoperative self-perceived quality of life is not negatively affected by preoperative brace treatment.
    Orthopedics 09/2009; 32(8). · 1.05 Impact Factor