Improvement in quality of life following surgery for adolescent idiopathic scoliosis.

Abstract:

STUDY DESIGN:We used the Climent Quality of Life for Spinal Deformities Scale prospectively in a nonrandomized prospective comparative cohort of operative versus observational management of adolescent idiopathic scoliosis. OBJECTIVE:To compare the change in disease-specific quality of life associated with operating on adolescents with idiopathic scoliosis, to the change in disease-specific quality of life among observed scoliosis patients with a similar 2-year follow-up period. SUMMARY OF BACKGROUND DATA:The immediate effect of scoliosis surgery on quality of life from a patient perspective has not been properly documented but should play a role in the patient's decision to operate. METHODS:At a single tertiary referral children's hospital spinal clinic, 119 patients undergoing scoliosis surgery and 42 patients undergoing observation only for scoliosis were enrolled in a prospective study, including preoperative and postoperative spine-specific quality of life. Change in quality of life after 2 years of follow-up among operated versus observed patients (adjusted for baseline quality of life) was used to estimate the short-term benefit of scoliosis surgery. RESULTS:The operated group experienced an increase in quality of life of 4.3 points (95% confidence interval, 0.69-7.88) on the 115-point Climent scale. Although statistically significant, this increase was lower than the 5.5-point cutoff we had defined a priori as clinically significant. CONCLUSION:Scoliosis surgery results in a small increase in spine-related quality of life at 2 years. This increase is of questionable clinical significance. Decisions to operate on adolescents with scoliosis should acknowledge modest expectations about short-term gains in quality of life.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Howard A,Donaldson S,Hedden D,Stephens D,Alman B,Wright J

doi

10.1097/BRS.0b013e31815a51cd

subject

Has Abstract

pub_date

2007-11-15 00:00:00

pages

2715-8

issue

24

eissn

0362-2436

issn

1528-1159

pii

00007632-200711150-00014

journal_volume

32

pub_type

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