title: Quality of life in patients treated surgically for scoliosis: longer than sixteen-year follow-up.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  To evaluate the long-term quality of life (QOL) of patients treated surgically for scoliosis.
  
  
  BACKGROUND
  Measures of long-term outcome after surgery for scoliosis have focused mainly on radiologic changes. However, QOL issues such as working status and marital status are the subjects of greatest concern for patients who will undergo surgical treatment for scoliosis.
  
  
  METHODS
  Thirty-two patients treated surgically for scoliosis between 1976 and 1989 were included in this study. The mean duration of follow-up was 21.1 years. Eighteen patients had adolescent idiopathic scoliosis, 8 congenital scoliosis, and 6 symptomatic scoliosis. We evaluated long-term outcome by direct interview with patients. Working status, marital status, and childbearing were determined in addition to clinical and radiologic evaluation. Patients were also asked to fill out the short form (SF)-36 and Scoliosis Research Society (SRS)-22 questionnaires.
  
  
  RESULTS
  Twenty-seven patients (84.4%) were or had been engaged in various occupations without marked difficulty. Although none of the male patients was married, 62.5% of the female patients were married. Half of the female patients had delivered babies after surgery, and the mean number of such children was 1.83. On the SF-36, none of the scores for subjects with idiopathic or congenital scoliosis were markedly different from those for age-matched healthy controls. Multivariate logistic regression analysis revealed that marked preoperative Cobb angle and positive sagittal balance at the most recent follow-up were significantly associated with increased odds ratio for poor scores on the SRS-22.
  
  
  CONCLUSIONS
  We evaluated long-term QOL in patients treated surgically for scoliosis, and found that it was not impaired, particularly in the case of patients with idiopathic or congenital scoliosis. Larger preoperative Cobb angle and positive sagittal balance at the most recent follow-up were related to poor outcome in QOL as assessed by the SRS-22.
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Takayama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D009984:Orthopedic Fixation Devices; D011788:Quality of Life; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult