The long-term outcome of patients treated operatively and non-operatively for scoliosis deformity secondary to spina bifida.

Autor:	Khoshbin A; Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada., Vivas L; Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada., Law PW; Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada., Stephens D; Hospital for Sick Children, 5270 555 University Avenue, Hill Wing, M5G 1X8 Toronto, Ontario, Canada., Davis AM; Toronto Western Hospital, MP11-322, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada., Howard A; Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada., Jarvis JG; Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada., Wright JG; Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The bone & joint journal [Bone Joint J] 2014 Sep; Vol. 96-B (9), pp. 1244-51.
DOI:	10.1302/0301-620X.96B9.33857
Abstrakt:	The purpose of this study was to evaluate the long-term outcome of adults with spina bifida cystica (SBC) who had been treated either operatively or non-operatively for scoliosis during childhood. We reviewed 45 patients with a SBC scoliosis (Cobb angle ≥ 50º) who had been treated at one of two children's hospitals between 1991 and 2007. Of these, 34 (75.6%) had been treated operatively and 11 (24.4%) non-operatively. After a mean follow-up of 14.1 years (standard deviation (sd) 4.3) clinical, radiological and health-related quality of life (HRQOL) outcomes were evaluated using the Spina Bifida Spine Questionnaire (SBSQ) and the 36-Item Short Form Health Survey (SF-36). Although patients in the two groups were demographically similar, those who had undergone surgery had a larger mean Cobb angle (88.0º (sd 20.5; 50.0 to 122.0) ; : versus 65.7º (sd 22.0; 51.0 to 115.0); p < 0.01) and a larger mean clavicle-rib intersection difference (12.3 mm; (sd 8.5; 1 to 37); versus 4.1 mm, (sd 5.9; 0 to 16); p = 0.01) than those treated non-operatively. Both groups were statistically similar at follow-up with respect to walking capacity, neurological motor level, sitting balance and health-related quality of life (HRQOL) outcomes. Spinal fusion in SBC scoliosis corrects coronal deformity and stops progression of the curve but has no clear effect on HRQOL. (©2014 The British Editorial Society of Bone & Joint Surgery.)
Databáze:	MEDLINE
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