1.Compensatory Pelvic Retro-Rotation Associated with a Decreased Quality of Life in Patients with Normal Sagittal Balance
Tetsuya SHIMOKAWA ; Kei MIYAMOTO ; Akira HIOKI ; Takahiro MASUDA ; Kazunari FUSHIMI ; Hiroyasu OGAWA ; Kazuichiro OHNISHI ; Haruhiko AKIYAMA
Asian Spine Journal 2022;16(2):241-247
Methods:
Overall, 134 subjects aged ≥20 years with lower back pain were included (104 females; mean age, 70±9.8 years). Sagittal vertical alignment (SVA) and PT were analyzed radiographically. Patients were stratified into three groups based on SVA values: good alignment (group G), intermediate alignment (group I), and poor sagittal alignment (group P). Patients in group I were further categorized into two groups: low PT and high PT. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was used for clinical assessment, and the scores were compared between groups.
Results:
As SVA increased, PT and lumbar lordosis (LL) increased and decreased, respectively. PT and LL differed significantly between groups G and P (p<0.01 for each comparison). Within group I, there was no significant difference in SVA between the high PT and low PT groups, suggesting that the high PT group had acquired a compensated sagittal balance. Importantly, all domains in the JOABPEQ (except for lower back pain) were significantly lower in the high PT group than in the low PT group (p<0.05 for every comparison).
Conclusions
This study showed that focusing solely on SVA as a single indicator can cause important losses in QOL to be overlooked in patients with lumbar disorders. Although pelvic retroversion can compensate for sagittal balance, it is associated with a significant decrease in QOL. To improve the assessment of patients with lumbar disorders, PT should be considered besides SVA.
2.Importance of Extracting Intergroup Differences by Treatment Purpose and Content of Free-Response Answers That Should Be Considered when Screening for Pain by Administering the “Ease of Living Questionnaire” to Patients Undergoing Initial Radiotherapy
Takako MORI ; Setsuko KAWAMATA ; Satoru TAKAHASHI ; Kazunari OGAWA ; Masaru WAKATSUKI
Palliative Care Research 2019;14(1):1-8
Background: We began conducting pain screenings using an in-house version of the “Ease of Living Questionnaire” for patients undergoing initial radiotherapy. Purpose: The purpose of this study was to classify patients undergoing radiotherapy for different medical purposes and to verify the differences in the responses between the groups identified. Methods: The “Ease of Living Questionnaire” was administered to all adult patients with cancer undergoing initial radiotherapy , and the responses were analyzed together with data concerning the patients’ background characteristics that were extracted from medical records. Results: A total of 543 responses to the questionnaire were collected, and the patients were divided into a palliative group (177), curative group (189), preoperative group (19), and postoperative group (158); statistical differences were observed with respect to patient gender, age, and target disease. Mental and physical distresses were more pronounced in the palliative group compared to the other three groups. Although psychosocial need was high with respect to the questionnaire items concerning symptoms and treatments/activities of daily living, the independent sensitivity values of the check fields were 0.29-0.65 and 0.08-0.38, respectively. Intergroup differences were observed with respect to symptoms and treatment/economic need as well as social security/occupational need. Conclusion: In order to gain an understanding of patient needs, we believe that it is necessary to take sufficient action in consideration of the content of free-response answers based on differences in background by treatment purpose.