Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis
| Autor: | Michael J. Yaszemski, David W. Polly, Vickie M. Treder, Fady J. Baky, A. Noelle Larson, Yaser M. K. Baghdadi, Ali Ashraf |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Population Idiopathic scoliosis Observation Scoliosis 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine In patient education Child Retrospective Studies Health related quality of life 030222 orthopedics education.field_of_study Braces business.industry Evidence-based medicine medicine.disease Spinal Fusion Orthopedic surgery Cohort Quality of Life Female business 030217 neurology & neurosurgery |
| Zdroj: | Spine deformity. 7(3) |
| ISSN: | 2212-1358 |
| Popis: | Study Design Longitudinal cohort. Objectives To determine the patient-reported functional outcomes and need for related surgical procedures in a US cohort of adolescent idiopathic scoliosis (AIS) patients with minimum 20-year follow-up. Summary of Background Data There is limited information regarding the long-term outcomes of scoliosis treatment in the US population. Methods A novel population of patients who underwent pediatric treatment for AIS with minimum 20-year follow-up was identified. Search of a single-center diagnostic registry generated 337 patients who fulfilled the inclusion criteria (AIS, curve magnitude >35°, and childhood treatment with bracing, surgery, or observation from 1975 to 1992). Any additional spine surgery as well as EQ5D, ODI, SRS 22, SAQ were determined. A total of 180 patients were included (mean of 30-year follow-up, range 20-37). Childhood treatment entailed bracing (41 patients), surgery (103 patients), and observation (36 patients). Results During the study period, only 1 of the 41 bracing patients underwent additional scoliosis-related spine surgery, whereas 5 of the 36 patients in the observation cohort underwent scoliosis surgery as adults. Seven of 103 childhood surgical patients required additional revision surgery as adults. Fifteen patients (4 braced, 7 fusion, and 4 observed) underwent chest wall surgery as adults. SRS scores were around 10% worse compared to population-based controls, with the exception of SRS mental health scores, which were similar to controls. Overall, 5.6% of patients were on disability, with no difference between operative and nonoperative groups. Conclusion We found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years' follow-up. Level of Evidence Level III, therapeutic. |
| Databáze: | OpenAIRE |
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