Quality of life and back pain: outcome 16.7 years after Harrington instrumentation.
METHODS
A study on the quality of life of 82 patients with idiopathic scoliosis treated with Harrington instrumentation.


OBJECTIVE
To analyze long-term health-related quality of life and low back pain an average of 16.7 years after surgery.


BACKGROUND
Quality of life evaluated by self-assessment questionnaires is an accepted outcome measure of surgical procedures. The purpose of this study was to evaluate the health status with the German version of internationally accepted and psychometrically tested questionnaires.


METHODS
Quality of life was measured with the Short Form-36 health profile. Low back pain was assessed using the Roland-Morris Questionnaire. Demographic data (age, sex, follow-up time), radiographic analysis (Kings classification, Cobb angle, extension and site of fusion), and rib cage deformity were correlated with these data. Radiologic parameters were analyzed longitudinally.


RESULTS
In comparison with the age-matched healthy population, there was no significant difference in the physical Short Form-36 scale (P = 0.98). Surgically treated patients showed significantly lower scores than at baseline in the psychologic Short Form-36 scale (P = 0.005); vitality (P < 0.001), general mental health (P = 0.003), and role activities because of emotional problems (P < 0.001) were significantly different from those of the age-matched population. Sixty-five (79.3%) of the 82 patients reported no or occasional back pain in the Roland-Morris Questionnaire. Five patients (6.1%) reported chronic back pain. Neither patient age at the time of surgery (P = 0.74) nor time of follow-up (P = 0.44), type of scoliosis (P = 0.56), or extent of fusion (P = 0.12) was associated with health-related quality of life or pain. The size of the preoperative (P = 0.06) and postoperative (P = 0.12) curves and preoperative (P = 0.28) and postoperative (P = 0.7) rib cage deformities did not correlate with the data of the Short Form-36 scale and the Roland-Morris Questionnaire.


CONCLUSIONS
In comparison with the age-matched population, the long-term effect of surgery does not affect the physical quality of life. The psychologic health status is, however, significantly impaired. Neither the type of curve, the size of scoliosis, nor the rib cage deformity influences the data.
Department of Orthopedic Surgery, University of Muenster, Germany. chrgoetze@uni-muenster.de
Christian
C
Götze
Ulf R
UR
Liljenqvist
Astrid
A
Slomka
Hans Guenther
HG
Götze
Joern
J
Steinbeck
D000293:Adolescent; D000328:Adult; D000886:Anthropometry / Q000295:instrumentation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D008297:Male; D011788:Quality of Life / Q000523:psychology; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome