Mental health of patients with adolescent idiopathic scoliosis and their parents in China: a cross-sectional survey.

BACKGROUNDS: Adolescent idiopathic scoliosis (AIS) is an adolescent onset spinal deformity, which can negatively affect the mental health of these patients. But no studies about their parental mental health have been reported so far. In this study, the parental mental health of AIS patients and the associated risk factors were evaluated by a cross-sectional survey. METHODS: 64 AIS patients who underwent conservative or surgical treatments in our hospital from April 2017 to March 2018, and their parents were enrolled in the AIS group. 85 parents of healthy children were enrolled in the control group. Depression and anxiety were separately assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Spearman correlation coefficients were first estimated to investigate the relationships among the parental PHQ-9/GAD-7 scores and the patient's PHQ-9/GAD-7 scores in the AIS group. Then, the morbidities of the parental probable major depressive disorder (pMDD, PHQ score ≥ 10) and probable general anxiety disorder (pGAD, GAD-7 score ≥ 10) were compared between the AIS and control groups. Third, the potential risk factors for parental pMDD or pGAD in the AIS group were compared using the chi-squared test or Student's t-test, respectively. Finally, the uneven distributive variates were analyzed using the binary logistic regression model. RESULTS: Both parental depression and anxiety were moderately associated with those of the patients (r = 0.448~0.515, p < 0.01) in the AIS group, respectively. The morbidities of parental pMDD and pGAD in the AIS group were 14.1%, significantly higher than those in the control group (pMDD = 4.7%, p = 0.045; pGAD = 3.5%, p = 0.019). A Cobb angle of the major curve ≥50° (p = 0.034, odds ratio [OR] = 8.264), patients with pMDD (p = 0.018, OR = 17.576), and low education level of the parents (p = 0.026, OR = 0.122) were the risk factors of parental pMDD. Household income < 8000 rmb/month was the risk factor for parental pGAD (p = 0.021). CONCLUSIONS: The morbidities of pMDD and pGAD in parents of AIS patients were higher than those in parents of healthy children. Parental depression and anxiety were closely associated with their children's depression and anxiety. Therefore, the parental mental health of AIS patients should be paid attention to, especially for those parents with risk factors.

Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study.

BACKGROUNDS: Rare study has been conducted to detect risk factors of perioperative complications, which are closely related to preoperative status of the patients and surgical stress. The aim of this study is to detect these relationships in degenerative scoliosis (DS) patients. METHODS: Perioperative complications of 226 cases with DS (56 males and 170 females; 65.5 ± 8.1 years old), who accepted posterior fusion in our hospital from January, 2013 to July, 2017, were retrospectively reviewed. Potential risk factors were first compared between patients with or without perioperative complications using student t test or Chi-squared test. Then, the unevenly distributed variables between the two groups were analyzed with binary logistic regression model. RESULTS: All patients separately underwent decompression with short limited instrumentation (116, 51.3%) or with long instrumentation for correction (110, 48.7%). The mean operation duration (OD) was 216.9 ± 64.2 min and the average amount of bleeding was 587.4 ± 357.2 ml. 44 cases (19.5%)suffered from the complications during the perioperative phase, including incision complications (5.3%), urinary infection (3.5%), dura tears/cerebrospinal fluid (CSF) leakages (3.5%) and new neurological deficits (2.7%). Hospital stay was significantly extended for the complications (p < 0.001). Univariate analysis showed that OD (p < 0.001), bleeding (p = 0.014), American Standards Association (ASA) grade > 2 (p = 0.011) and RBC transfusion≥4 U(p = 0.028) were associated with these complications. Multivariate logistic regressions revealed that only ASA grade > 2(p = 0.011, Odds Ratio[OR] = 4.104, 95% Confidence Interval[CI] = 1.413~ 11.917) and OD (p = 0.013, OR = 2.697, 95% CI = 1.233~ 5.899) were the independent risk factors. CONCLUSIONS: The high morbidity of perioperative complications for posterior spinal fusion would significantly extend hospital stay of DS patients. It was independently related to higher ASA grade and longer OD.

FOXJ2 expression in rat spinal cord after injury and its role in inflammation.

Foxj2 (forkhead box J2), a novel member of the forkhead/HNF3 family, binds DNA with a dual sequence specificity. It may play a role in maintenance and survival of developing and adult neurons. However, its expression and function in the central nervous system lesion are still unclear. In this study, we performed a spinal cord injury (SCI) model in adult Sprague-Dawley rats and investigated the dynamic changes of Foxj2 expression in the spinal cord. Western blot analysis revealed that Foxj2 was present in normal spinal cord. It gradually increased, reached a peak at day 5 after SCI, and then declined during the following days. Double immunofluorescence staining revealed wide expression of Foxj2, which is detected in neurons and astrocytes. After injury, Foxj2 expression was increased predominantly in astrocytes, which highly expressed proliferating cell nuclear antigen, a marker for proliferating cells. And knockdown of Foxj2 in cultured primary astrocytes by siRNA showed that Foxj2 played an important role in lipopolysaccharide-induced inflammatory responses. These results suggested that Foxj2 may be involved in the pathophysiology of SCI, and further research is needed to have a good understanding of its function and mechanism.