Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 17:94:165-170.
doi: 10.2340/17453674.2023.11962.

Health-related quality of life after segmental pedicle screw instrumentation: a matched comparison of patients with neuromuscular and adolescent idiopathic scoliosis

Venla Soini  1 , Johanna Syvänen  2 , Linda Helenius  3 , Arimatias Raitio  2 , Ilkka Helenius  4
Affiliations

Health-related quality of life after segmental pedicle screw instrumentation: a matched comparison of patients with neuromuscular and adolescent idiopathic scoliosis

Venla Soini et al. Acta Orthop. .

Abstract

Background and purpose: Progressive neuromuscular scoliosis (NMS) often requires a long instrumented spinal fusion to improve health-related quality of life (HRQoL) and sitting balance. Segmental pedicle screw instrumentation improves HRQoL in patients with adolescent idiopathic scoliosis (AIS), but data on NMS is limited. We aimed to assess the impact of spinal fusion on HRQoL in NMS patients.

Patients and methods: We conducted a retrospective case-control study with prospective data collection of NMS patients undergoing posterior spinal fusion at a tertiary level hospital in 2009-2021. 2 controls with AIS matched for sex and age were selected for each NMS patient. The Scoliosis Research Society-24 (SRS-24) questionnaire was utilized for pre- and postoperative HRQoL assessment. Follow-up time was a minimum of 2 years.

Results: 60 NMS and 120 AIS patients were included in the analysis, and the mean age (SD) at operation was 14.6 (2.7) in NMS and 15.7 (2.5) in AIS groups. Total SRS score and all domains showed a significant improvement in NMS patients (p < 0.05). Total SRS score improved more (p < 0.001), while pain score improved less (p = 0.04) in NMS (change [95% CI], 0.31 [0.05-0.58] and 0.55 [0.27-0.81]) compared with AIS (0.01 [-0.10 to 0.12] and 0.88 [0.74-1.03]). Postoperative self-image was significantly better in NMS than in AIS at 2-year follow up (p = 0.01). Pelvic instrumentation reduced improvements in the SRS domains.

Conclusion: HRQoL in NMS patients improved significantly after spinal fusion, and these benefits are comparable to those of AIS patients.

PubMed Disclaimer

Figures

None
Patient flow chart
See this image and copyright information in PMC

References

    1. Vialle R, Thevenin-Lemoine C, Mary P. Neuromuscular scoliosis. Orthop Traumatol Surg Res 2013; 99(1 Suppl.): S124-S139. doi: 10.1016/j.otsr.2012.11.002. - DOI - PubMed
    1. Hägglund G, Pettersson K, Czuba T, Persson-Bunke M, Rodby-Bousquet E. Incidence of scoliosis in cerebral palsy. Acta Orthop 2018; 89(4): 443-7. doi: 10.1080/17453674.2018.1450091. - DOI - PMC - PubMed
    1. Saito N, Ebara S, Ohotsuka K, Kumeta H, Takaoka K. Natural history of scoliosis in spastic cerebral palsy. Lancet 1998; 351(9117): 1687-92. doi: 10.1016/S0140-6736(98)01302-6. - DOI - PubMed
    1. Helenius I J, Viehweger E, Castelein R M. Cerebral palsy with dislocated hip and scoliosis: what to deal with first? J Child Orthop 2020; 14(1): 24-9. doi: 10.1302/1863-2548.14.190099. - DOI - PMC - PubMed
    1. Suresh K V, Ikwuezunma I, Margalit A, Sponseller P D. Spinal fusion with sacral alar iliac pelvic fixation in severe neuromuscular scoliosis. JBJS Essent Surg Tech 2021; 11(3):e20.00060 doi: 10.2106/JBJS.ST.20.00060. - DOI - PMC - PubMed