Surgical and Health-related Quality-of-Life Outcomes of Growing Rod "Graduates" With Severe versus Moderate Early-onset Scoliosis

Ilkka J. Helenius, Paul D. Sponseller, Anna McClung, Jeff B. Pawelek, Muharrem Yazici, John B. Emans, George H. Thompson, Charles E Johnston, Suken A. Shah, Behrooz A. Akbarnia

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Abstract

STUDY DESIGN: A retrospective review of a prospective, multicenter database. OBJECTIVE: The aim of this study was to compare surgical and quality-of-life outcomes at the end of growing rod treatment in patients with severe versus moderate early-onset scoliosis (EOS). SUMMARY OF BACKGROUND DATA: Knowledge of the outcomes of severe EOS after growth-friendly treatment is limited because this condition is uncommon. METHODS: We identified 40 children with severe EOS (major curve ≥90°) treated with growing rods before age 10 with minimum 2-year follow-up after last lengthening or final fusion. From the same registry, we matched 40 patients with moderate EOS (major curve < 90°). Twenty-seven patients in the severe group and 12 in the moderate group underwent final fusion (P < 0.001). RESULTS: Mean preoperative curves were 102° (range, 90°-139°) in the severe group and 63° (range, 33°-88°) in the moderate group (P < 0.001). At final follow-up, mean curves were 56° (range, 10°-91°) and 36° (range, 12°-89°), respectively (P < 0.001). Fourteen (35%) children in the severe group and 32 (80%) in the moderate group had scoliosis of < 45° at final follow-up [risk ratio (RR), 0.44; 95% confidence interval (95% CI), 0.20-0.57]. At final follow-up, 30 (75%) children in the severe group and 35 (88%) in the moderate group had achieved T1-T12 length of ≥18 cm (RR, 0.86; 95% CI, 0.70-1.09). Thirty-five children in the severe group and 26 in the moderate group had at least one complication (RR, 1.35; 95% CI, 1.05-1.73). Mean 24-Item Early-Onset Scoliosis Questionnaire scores were similar between groups at final follow-up. CONCLUSION: Delaying surgery until the major curve has progressed beyond 90° is associated with larger residual deformity and more complications than treating at a lesser curve magnitude. Quality-of-life outcomes were similar between those with severe and moderate EOS.3.

Original languageEnglish (US)
Pages (from-to)698-706
Number of pages9
JournalSpine
Volume44
Issue number10
DOIs
StatePublished - May 15 2019
Externally publishedYes

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ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Helenius, I. J., Sponseller, P. D., McClung, A., Pawelek, J. B., Yazici, M., Emans, J. B., Thompson, G. H., Johnston, C. E., Shah, S. A., & Akbarnia, B. A. (2019). Surgical and Health-related Quality-of-Life Outcomes of Growing Rod "Graduates" With Severe versus Moderate Early-onset Scoliosis. Spine, 44(10), 698-706. https://doi.org/10.1097/BRS.0000000000002922