Impact of surgical waiting time on paediatric spinal deformity patients

Calman, Riana; Smithers, Troy; Rowan, Robert L.

doi:10.1111/ans.12196

Cited by 21 publications

(23 citation statements)

References 10 publications

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“…Due to underfunding, the surgical treatment of complex spinal deformities in publicly funded healthcare systems has been subjected to steadily lengthening waiting lists 4 - 7 . The long waiting times for deformity correction have been associated with clinical and radiological worsening of the deformity, reduced corrective potential, the need for more complex procedures, increased morbidity and complication rates, increased anxiety of patients and parents and lower scores on health-related quality of life questionnaires 8 - 11 .…”

Section: Introductionmentioning

confidence: 99%

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

Neto¹,

Herrero²,

Pácola³

et al. 2017

Clinics

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OBJECTIVE:Underfunding of the surgical treatment of complex spinal deformities has been an important reason for the steadily growing waiting lists in publicly funded healthcare systems. The aim of this study is to characterize the management of the treatment of spinal deformities in the public healthcare system.METHODS:A cross-sectional study of 60 patients with complex pediatric spinal deformities waiting for treatment in December 2013 was performed. The evaluated parameters were place of origin, waiting time until first assessment at a specialized spine care center, waiting time for the surgical treatment, and need for implants not reimbursed by the healthcare system.RESULTS:Ninety-one percent of the patients lived in São Paulo State (33% from Ribeirão Preto - DRS XIII). Patients waited for 0.5 to 48.0 months for referral, and the waiting times for surgery ranged from 2 to 117 months. Forty-five percent of the patients required implants for the surgical procedure that were not available.CONCLUSION:The current management of patients with spinal deformities in the public healthcare system does not provide adequate treatment for these patients in our region. They experience long waiting periods for referral and prolonged waiting times to receive surgical treatment; additionally, many of the necessary procedures are not reimbursed by the public healthcare system.

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Section: Introductionmentioning

confidence: 99%

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

Neto¹,

Herrero²,

Pácola³

et al. 2017

Clinics

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“…The study observed that with an increase in the length of time waiting for the surgery there was a statistically significant decrease in the domains of pain, satisfaction with the treatment, and appearance. 20 Ahn et al analyzed 88 patients with adolescent idiopathic scoliosis who were on a surgery waiting list for at least six months, and they noted a need for additional surgery in thirteen (14.8%) of the patients due to progression of the curvature as opposed to only in two (1.6%) adolescents who had been waiting for less than six months. Other findings were an increase in surgical time and in the duration of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Implications of the Surgical Waiting List for the Treatment of Spinal Deformity

et al. 2018

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Objective: The aim of this study was to evaluate the implications of long waiting times on surgery lists for the treatment of patients with scoliosis. Methods: Radiographs of 87 patients with scoliosis who had been on the waiting list for surgery for more than six months were selected. Two surgeons answered questionnaires analyzing the radiographs when entering the waiting list and the current images of each patient. Results: Data from 87 patients were analyzed. The mean waiting time for surgery was 21.7 months (ranging from seven to 32 months). The average progression of the Cobb angle in the curvature was 21.1 degrees. Delayed surgery implied changes in surgical planning, such as greater need of instrumentation, osteotomies, and double approach. Conclusions: Long waiting lists have a significant negative impact on surgical morbidity of patients with scoliosis, since they increase the complexity of the surgery.

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“…[2-4] Over the past decade, SRS-30 had been widely applied in different areas of quality of life of patients with different spinal deformities e.g. surgical waiting time[5], ethnic and cultural difference[6,7], satisfaction level on patients with Parkinson disease after surgery[8]. …”

Section: Introductionmentioning

confidence: 99%

HRQoL assessment by SRS-30 for Chinese patients with surgery for Adolescent Idiopathic Scoliosis (AIS)

Chau

Hui

et al. 2015

Scoliosis

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IntroductionHealth-related quality of life (HRQoL) outcome questionnaire, Scoliosis Research Society (SRS)-30, had been well received since its establishment in 2003. Literatures from Asia on the use of SRS-30 mainly focused on the translation process and validation process, but not on measuring outcomes, particularly in the Chinese community. We carried out a prospective cohort study to evaluate the HRQoL of Chinese AIS adolescents with severe scoliosis after surgery.MethodsOne hundred and four Chinese AIS patients with severe scoliosis undergoing posterior spinal fusion between 2009 and 2013 were recruited in this study. They completed SRS-30 questions before surgery, before hospital discharge, and at follow-up. Mean scores and percentages of individual scores in different domains, and composite scores in terms of subtotal and total scores were calculated referring to the scoring system. Gender-specific and period-specific descriptive analyses were described. Correlation of mean domain scores at the three time points were explored to look for any time-specific relationship. Linear regression analysis looking for potential risk factors on domain scores at different time points by gender were also carried out.ResultsMean age was 16.28 at surgery, and 83.6% were female. Significant correlations between pre-op scores and scores after surgery were observed in function/activity domain (p=0.05) in males, and pain (p=0.04) and satisfaction with management (p=0.04) domains in females. No gender difference in all 5 domain scores at the 3 time points was found. Pre-op maximum Cobb angle and corrected angle were found to be risk factors on self-image, as well as satisfaction with management, in male and female patients.ConclusionsThis is the first report on the evaluation of the clinical HRQoL outcomes of Chinese AIS patients with severe scoliosis after surgery. Medical professionals should pay attention to take care of the difference in personal perceptions of feelings between boys and girls. Special care should also be allocated to AIS patients, and try to arrange earlier surgical intervention.

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Impact of surgical waiting time on paediatric spinal deformity patients

Cited by 21 publications

References 10 publications

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

Community Care Administration of Spinal Deformities in the Brazilian Public Health System

Radiographic Implications of the Surgical Waiting List for the Treatment of Spinal Deformity

HRQoL assessment by SRS-30 for Chinese patients with surgery for Adolescent Idiopathic Scoliosis (AIS)

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