title: The long-term outcome of patients treated operatively and non-operatively for scoliosis deformity secondary to spina bifida.
abstract: The purpose of this study was to evaluate the long-term outcome of adults with spina bifida cystica (SBC) who had been treated either operatively or non-operatively for scoliosis during childhood. We reviewed 45 patients with a SBC scoliosis (Cobb angle ≥ 50º) who had been treated at one of two children's hospitals between 1991 and 2007. Of these, 34 (75.6%) had been treated operatively and 11 (24.4%) non-operatively. After a mean follow-up of 14.1 years (standard deviation (sd) 4.3) clinical, radiological and health-related quality of life (HRQOL) outcomes were evaluated using the Spina Bifida Spine Questionnaire (SBSQ) and the 36-Item Short Form Health Survey (SF-36). Although patients in the two groups were demographically similar, those who had undergone surgery had a larger mean Cobb angle (88.0º (sd 20.5; 50.0 to 122.0) ; : versus 65.7º (sd 22.0; 51.0 to 115.0); p < 0.01) and a larger mean clavicle-rib intersection difference (12.3 mm; (sd 8.5; 1 to 37); versus 4.1 mm, (sd 5.9; 0 to 16); p = 0.01) than those treated non-operatively. Both groups were statistically similar at follow-up with respect to walking capacity, neurological motor level, sitting balance and health-related quality of life (HRQOL) outcomes. Spinal fusion in SBC scoliosis corrects coronal deformity and stops progression of the curve but has no clear effect on HRQOL.
authors.affiliation: Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Khoshbin
authors.affiliation: Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Vivas
authors.affiliation: Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: P W
authors.initials: PW
authors.lastname: Law
authors.affiliation: Hospital for Sick Children, 5270 555 University Avenue, Hill Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Stephens
authors.affiliation: Toronto Western Hospital, MP11-322, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Davis
authors.affiliation: Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Howard
authors.affiliation: Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.
authors.forename: J G
authors.initials: JG
authors.lastname: Jarvis
authors.affiliation: Hospital for Sick Children, 1254 - 555 University Avenue, Elm Wing, M5G 1X8 Toronto, Ontario, Canada.
authors.forename: J G
authors.initials: JG
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D001915:Braces; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D012600:Scoliosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D016137:Spina Bifida Cystica / Q000150:complications*; D013123:Spinal Fusion; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014853:Walkers; D055815:Young Adult
keywords: Myelomeningocele; Non-operative; Quality of life; Scoliosis; Spina bifida