Long-term follow-up of patients with idiopathic scoliosis

Birch, Nick

doi:10.1302/0301-620x.105b2.bjj-2022-1298

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Although lifelong follow-up places an added burden on both patients and healthcare systems, the mortality observed here highlights the vulnerability of this cohort. With this vulnerability in mind, we agree with the opinion expressed by others emphasizing the ethical obligations and requirement to improve the understanding of outcomes imposed on those who treat children with scoliosis 22 …”

Section: Discussionsupporting

confidence: 54%

“…With this vulnerability in mind, we agree with the opinion expressed by others emphasizing the ethical obligations and requirement to improve the understanding of outcomes imposed on those who treat children with scoliosis. 22 In conclusion, this study, the largest to date, offers a comprehensive investigation into the long-term outcomes of patients with congenital scoliosis who underwent in situ fusion. It provides valuable insights into unplanned revisions, health-related quality of life, educational achievement, employment, and mortality rates compared to the general population.…”

Section: Discussionmentioning

confidence: 90%

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Functional Outcomes of Congenital Scoliosis at a Mean 35-Year Follow-up Post In Situ Fusion. Revisiting Patients From the 2002 Goldberg et al Study

Kelly,

Alberghina,

McCabe

et al. 2024

Journal of Pediatric Orthopaedics

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Background: The management of congenital scoliosis poses a significant challenge for treating surgeons. The aim of our study was to provide insight into the long-term clinical results of spinal fusion in congenital scoliosis. Methods: We performed a retrospective review of the scoliosis database in our institution for the period 1976 until 2002 identifying 43 patients with congenital scoliosis who underwent spinal fusion. Patient demographics, diagnosis, levels fused, and radiographs were evaluated. Patients were evaluated for unplanned return to the operating room (UPROR) via SRS 22, EQ5D–5L, and Oswestry Disability Index (ODI). Results: Of the 43 patients who fulfilled the inclusion criteria, 22 patients agreed to participate, 3 patients were known to be deceased and 18 patients were lost to follow-up or declined to participate and were excluded. The mean age of the respondents was 40.7 years (range, 30 to 47 y) with a mean follow-up from index surgery of 35 years (range, 20 to 44 y). At most recent follow-up, 12 patients (54%) underwent UPROR. The mean age at diagnosis was 3.4 years (range, birth to 11.5 y), and the mean age for first surgery was 5.8 years (range, 1 to 13 y). As regards radiologic follow-up; the mean number of levels fused was 5.2 (range, 2 to 12). Thoracic fusion was performed in 17 patients (77%). The mean T1 to T12 height at index surgery and maturity was 166 mm (range, 130 to 240 mm) and 202 mm (range, 125 to 270 mm), respectively. The mean functional scores at follow-up were SRS 22: 4.5 (range, 2.4 to 5), cumulative EQ5D-5L score 7.2 (range, 5 to 15), and ODI: 8% (range, 2 to 30%). All respondents completed high school, 10 patients (45%) completed university, and 2 patients were awarded doctorates. Currently, 17 patients (77%) are in paid employment. Conclusions: This report constitutes the largest series of patients treated by spinal arthrodesis for congenital scoliosis followed into maturity. We demonstrate the thorax continues to grow after index fusion, patient-reported outcomes were satisfactory with superior educational and employment rates and unplanned return to theatre is rare in adult life. Level of evidence: Therapeutic Level IV.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 90%

Functional Outcomes of Congenital Scoliosis at a Mean 35-Year Follow-up Post In Situ Fusion. Revisiting Patients From the 2002 Goldberg et al Study

Kelly,

Alberghina,

McCabe

et al. 2024

Journal of Pediatric Orthopaedics

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“…Enkel billeddiagnostikk med røntgen, for eksempel hvert femte år, av uopererte med Cobbs vinkel over 30 grader, vil kunne påvise tiltagende idiopatisk og degenerativ skoliose. Tidligere kirurgi gir mindre smerter og funksjonsnedsettelse i etterkant (2,4,5,8,9).…”

Section: Brudd På Lov Om Pasientrettigheter Og Helsepersonellunclassified

Better follow-up of idiopathic scoliosis

Rogne

2024

Tidsskriftet

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Sigbjørn Rogne er ph.d., overlege og spesialist i fordøyelsessykdommer og geriatri. Han ble operert for idiopatisk skoliose i 2022. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Ortopeder bør sørge for bedre og mer tilrettelagt behandling av pasienter med idiopatisk skoliose.Idiopatisk skoliose, økende ryggskjevhet av ukjent årsak, har en prevalens på 2-3 % og påvises oftest i barne-og ungdomsårene (1, 2). Ved moderat til stor feilstilling er den såkalte Cobbs vinkel 25-45 grader. Vinkelen måles ut ifra de to mest vinklede ryggvirvlene i det skjeve partiet. Behandling av tilstanden frem til vekstslutt er å bruke korsett (1). Ved større skjevhet enn dette, er det aktuelt med kirurgi med oppretting og avstiving av ryggen. Det er et vanskelig valg ettersom det gir livslang funksjonsnedsettelse (1-3).Skjevhet etter avsluttet vekst hos uopererte, overbelaster ryggvirvlene. Etter år og tiår kan ryggvirvler degenerere, slik at skjevheten også forverres av degenerativ skoliose (2,4,5). Når kompensasjonsmekanismene er oppbrukt, tilkommer smerter fra ryggmuskulatur og lumbal spinal stenose (2,4,5). Osteoporose som skyldes alder, og lavt aktivitetsnivå grunnet ryggsmerter, kan gi dårlig skruefeste og hindre kirurgi med oppretting og avstiving av ryggen. Fordeler med tidlig kirurgi er mindre degenerativ skoliose og funksjonsnedsettelse, siden mindre må opprettes og avstives, samt bedre skruefeste (2,5,6).

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“…1 Untreated AIS will cause progressive back pain and poorer health-related quality of life. [2][3][4][5][6] Untreated patients who progress to severe thoracic curvature will suffer deformity along with cosmetic and mental health concerns, as well as compromised pulmonary function. [7][8][9][10] Common treatment for AIS includes observation, bracing, and surgery.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of bracing to achieve curve regression in adolescent idiopathic scoliosis

Tang,

Cheung,

Cheung

2024

Bone Joint J

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AimsTo systematically evaluate whether bracing can effectively achieve curve regression in patients with adolescent idiopathic scoliosis (AIS), and to identify any predictors of curve regression after bracing.MethodsTwo independent reviewers performed a comprehensive literature search in PubMed, Ovid, Web of Science, Scopus, and Cochrane Library to obtain all published information about the effectiveness of bracing in achieving curve regression in AIS patients. Search terms included “brace treatment” or “bracing,” “idiopathic scoliosis,” and “curve regression” or “curve reduction.” Inclusion criteria were studies recruiting patients with AIS undergoing brace treatment and one of the study outcomes must be curve regression or reduction, defined as > 5° reduction in coronal Cobb angle of a major curve upon bracing completion. Exclusion criteria were studies including non-AIS patients, studies not reporting p-value or confidence interval, animal studies, case reports, case series, and systematic reviews. The GRADE approach to assessing quality of evidence was used to evaluate each publication.ResultsAfter abstract and full-text screening, 205 out of 216 articles were excluded. The 11 included studies all reported occurrence of curve regression among AIS patients who were braced. Regression rate ranged from 16.7% to 100%. We found evidence that bracing is effective in achieving curve regression among compliant AIS patients eligible for bracing, i.e. curves of 25° to 40°. A similar effect was also found in patients with major curve sizes ranging from 40° to 60° when combined with scoliosis-specific exercises. There was also evidence showing that a low apical vertebral body height ratio, in-brace correction, smaller pre-brace Cobb angle, and daily pattern of brace-wear compliance predict curve regression after bracing.ConclusionBracing provides a corrective effect on scoliotic curves of AIS patients to achieve curve regression, given there is high compliance rate and the incorporation of exercises.Cite this article: Bone Joint J 2024;106-B(3):286–292.

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Long-term follow-up of patients with idiopathic scoliosis

Cited by 5 publications

References 15 publications

Functional Outcomes of Congenital Scoliosis at a Mean 35-Year Follow-up Post In Situ Fusion. Revisiting Patients From the 2002 Goldberg et al Study

Functional Outcomes of Congenital Scoliosis at a Mean 35-Year Follow-up Post In Situ Fusion. Revisiting Patients From the 2002 Goldberg et al Study

Better follow-up of idiopathic scoliosis

Effectiveness of bracing to achieve curve regression in adolescent idiopathic scoliosis

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