title: Postoperative quality of life in patients with progressive neuromuscular scoliosis and their parents.
abstract: BACKGROUND
  The functional level of children with progressive neuromuscular disease is a major factor that affects the quality of life (QOL) of parents. However, only a few publications have reported changes in the QOL of parents after correctional spinal surgery.
  
  
  OBJECTIVE
  The purpose was to compare changes in QOL for both patients and parents after spinal correctional surgery for better sitting balance and to analyze correlation among radiographic parameters, functional outcome, and QOL questionnaires. Finally, the QOL of patients and parents was compared with the population norm.
  
  
  METHODS
  This study is a retrospective analysis of prospectively gathered data.
  
  
  METHODS
  From 2008 to 2011, 58 patients who underwent correctional surgery for progressive neuromuscular scoliosis and their parents were enrolled.
  
  
  METHODS
  A Muscular Dystrophy Spine Questionnaire (MDSQ) and short-form questionnaire 36 (SF-36) were used.
  
  
  METHODS
  The gathered functional outcome and QOL data using MDSQ and SF-36 for both enrolled patients and parents were compared preoperatively, postoperatively at 3 months, and at 1-year follow-up.
  
  
  RESULTS
  Mean age was 15.0±4.1 years. Forty male and 18 female patients were enrolled. Mean follow-up was 38.4±13.7 months. Cobb angle was 61.5°±23.5° preoperatively, 39.0°±20.1° immediately postoperative, and 40.0°±20.2° at the final follow-up. Cobb angle, pelvic obliquity, and lumbar lordosis were significantly improved after surgery (p<.001). Among sitting-related questions, answers to questions 15 (sitting comfortably), 16 (change weight in wheelchair), 22 (sit all day), 24 (sit at table for meal), 26 (keep balance while sitting in wheelchair), and 27 (look good while sitting in wheelchair) were significantly improved after correctional surgery (p<.001). Regarding the SF-36 scales for patients, bodily pain and social functioning significantly improved postoperatively (p<.001).
  
  
  CONCLUSIONS
  Muscular Dystrophy Spine Questionnaire results indicated that patients had significantly improved sitting balance-related outcomes, whereas the SF-36 indicated improvements only in bodily pain and social functioning scales. For parents, no SF-36 scales improved significantly postoperatively. Accordingly, improved sitting balance and QOL for neuromuscular scoliosis patients after surgery do not necessarily increase parent QOL.
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Suk
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Baek
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Hak-Sun
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Hwan-Mo
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Orthopedic Surgery, International St Mary's Hospital, 291 Simgok-dong, Seo-Gu, Incheon 404-190, Republic of Korea. Electronic address: 144667@daum.net.
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009134:Muscular Atrophy, Spinal / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery*; D009136:Muscular Dystrophies / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery*; D010290:Parents / Q000523:psychology; D011184:Postoperative Period; D004856:Postural Balance; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D013123:Spinal Fusion / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Correctional surgery; Neuromuscular scoliosis; Parents; Population norm; Quality of life; SF-36