Bigger is better: larger thoracic height is associated with increased health related quality of life at skeletal maturity

Simhon, Matthew E.; Roye, Benjamin; Matsumoto, Hiroko; Garg, Sumeet; Samdani, Amer F.; Smith, John T.; Sponseller, Paul D.; Vitale, Michael G.

doi:10.1007/s43390-020-00095-4

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…To achieve a normal lung volume at maturity, a T1-T12 height of at least 22 cm has been recommended and studies have suggested improved QoL with increased thoracic height. [31][32][33] Our cohort was on average 8.3 years old at follow-up and further growth is to be expected. HRQoL as assessed with the EOSQ-24 reached a score of > 80 in most domains and was not significantly different between groups.…”

Section: Discussionmentioning

confidence: 96%

“…Thoracic and spinal height were similar in our study between surgical groups at most recent follow-up, with thoracic height reaching 18 cm and spinal height 28 cm. To achieve a normal lung volume at maturity, a T1-T12 height of at least 22 cm has been recommended and studies have suggested improved QoL with increased thoracic height 31–33. Our cohort was on average 8.3 years old at follow-up and further growth is to be expected.…”

Section: Discussionmentioning

confidence: 97%

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Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?

Gómez¹,

Ge²,

Boden³

et al. 2022

Journal of Pediatric Orthopaedics

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Background: The outcomes of congenital scoliosis (CS) patients undergoing hemivertebra (HV) resection surgery with a 2-level fusion versus a >2-level fusion are unclear. We hypothesized that CS patients undergoing HV resection and a >2-level fusion have decreased curve progression and reoperation rates compared with 2-level fusions. Methods: Retrospective review of prospectively collected data from a multicenter scoliosis database. Fifty-three CS patients (average age 4.5, range 1.2 to 10.9 y) at index surgery were included. Radiographic and surgical parameters, complications, as well as revision surgery rates were tracked at a minimum of 2-year follow-up. Results: Twenty-six patients had a 2-level fusion while 27 patients had a >2-level fusion with similar age and body mass index between groups. The HV was located in the lumbar spine for 69% (18/26) 2-level fusions and 30% (8/27) >2-level fusions (P=0.006). Segmental HV scoliosis curve was smaller in 2-level fusions compared to >2-level fusions preoperatively (38 vs. 50 degrees, P=0.016) and at follow-up (25 vs. 34 degrees, P=0.038). Preoperative T2-T12 (28 vs. 41 degrees, P=0.013) and segmental kyphosis (11 vs. 23 degrees, P=0.046) were smaller in 2-level fusions, but did not differ significantly at postoperative follow-up (32 vs. 39 degrees, P=0.22; 13 vs. 11 degrees, P=0.64, respectively). Furthermore, the 2 groups did not significantly differ in terms of surgical complications (27% vs. 22%, P=0.69; 2-level fusion vs. >2-level fusion, respectively), unplanned revision surgery rate (23% vs. 22%, 0.94), growing rod placement or extension of spinal fusion (15% vs. 15%, P=0.95), or health-related quality of life per the EOS-Questionnaire 24 (EOSQ-24). Comparison of patients with or without the need for growing rod placement or posterior spinal fusion revealed no significant differences in all parameters analyzed. Conclusions: Two-level and >2-level fusions can control congenital curves successfully. No differences existed in curve correction, proximal junctional kyphosis or complications between short and long-level fusion after HV resection. Both short and long level fusions are viable options and generate similar risk of revision. The decision should be individualized by patient and surgeon.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?

Gómez¹,

Ge²,

Boden³

et al. 2022

Journal of Pediatric Orthopaedics

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“…Growth-friendly spinal implants (GFSI) have become a frequently applied technique to overcome the dilemma of severe and progressive deformity of the growing spine in early-onset scoliosis (EOS). It is accepted that the severity of the deformity determines pulmonary compromise and quality of life [ 14 , 15 ]. There are many promising reports, not least by our own group, that suggest a positive effect of GFSI on curve control and a better outcome at later definitive spinal fusion [ 1 , 11 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Smaller Intervertebral Disc Volume and More Disc Degeneration after Spinal Distraction in Scoliotic Children

Lippross¹,

Girmond²,

Lüders³

et al. 2021

JCM

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In recent decades, magnetically controlled growing rods (MCGR) were established to treat progressive early-onset scoliosis. The aim of this investigation was to assess the effect of long-term MCGR with continuous distraction on intervertebral discs in scoliotic children. Magnetic resonance imaging (MRI) of 33 children with spinal muscular atrophy was analyzed by grading intervertebral disc degeneration (IDD) and measuring intervertebral disc volume. Cohort I (n = 17) were children who had continuous spinal distraction with MCGRs for 5.1 years and MRI before (av. age 8.1) and after (av. age 13.4) MCGR treatment. Cohort II (n = 16, av. age 13.7) were patients without prior surgical treatment. Lumbar intervertebral disc volume of cohort I did not change during 5.1 years of MCGR treatment, whereas disc volumes were significantly larger in age- and disease-matched children without prior treatment (cohort II). Cohort I showed more IDD after MCGR treatment in comparison to early MRI studies of the same patients and children without surgical treatment. MRI data showed a volume reduction and disc degeneration of lower thoracic and lumbar intervertebral discs in scoliotic children after continuous spinal distraction with MCGRs. These effects were confirmed in the same subjects before and after treatment as well as in surgically untreated controls.

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“…3 This instrument has been utilized to measure and compare HRQoL and burden of care as outcomes of different treatments as well as its associations with various patient characteristics, such as EOS etiology. [8][9][10][11][12] Etiologies of EOS are divided conventionally into idiopathic, congenital, syndromic, and neuromuscular. Congenital scoliosis includes structural causes of curves such as hemivertebrae, fused ribs, VATER, etc.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Health-related Quality of Life in Children with Early Onset Scoliosis

Kunes¹,

Raman²,

Matsumoto³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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Background: Throughout the COVID-19 pandemic, decreases in health-related quality of life (HRQoL) have been observed in adults and children, with isolation, economic disruption, school closures, and health-related anxiety likely contributing. In this study, we evaluated the impact of COVID-19 on self-reported HRQoL of EOS patients and their caregivers using the Early Onset Scoliosis Questionnaire-24 (EOSQ-24).Methods: Patients with EOS and their caregivers enrolled in the Pediatric Spine Study Group (PSSG) registry with EOSQ scores from the year before the COVID-19 pandemic and the first year during COVID-19 were included. Two years of before-COVID-19 baseline EOSQ scores were recorded for each patient. We recorded patient medical demographics, scoliosis etiology, and comorbidities.Results: 618 patients met inclusion criteria (255 male, 363 female). All EOSQ subscores increased significantly from pre-COVID to early-COVID (p < 0.001, p < 0.05, respectively), though the mean difference was well below the proposed EOSQ-24 MCID. There was no evidence of change in Combined HRQoL or impact-and satisfactionrelated scores between early-COVID to late-COVID (p > 0.37). When stratified by etiology (40.3% idiopathic, 17.6% syndromic, 17.8% neuromuscular, 23.0% congenital), there was no evidence of decrease in the HRQoL combined score or other subscores in any subgroup between Pre-COVID and during COVID.

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Bigger is better: larger thoracic height is associated with increased health related quality of life at skeletal maturity

Cited by 9 publications

References 19 publications

Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?

Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?

Smaller Intervertebral Disc Volume and More Disc Degeneration after Spinal Distraction in Scoliotic Children

Impact of the COVID-19 Pandemic on Health-related Quality of Life in Children with Early Onset Scoliosis

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