Long-Term Health-Related Quality of Life (QOL) after Paediatric Spinal Deformity Surgery and Comparison with the General Population.

Abstract

QOL questionnaires assess patients' perception on surgical outcomes. We reviewed 1354 patients with spinal deformity. Four hundred and twenty-eight patients had >10 years of follow-up. The SRS-22r questionnaire was completed before surgery, at 6/12/24 months, 5-10 years and >10 years postoperatively. Patients with >10 years of follow-up completed the EQ-5D VAS/index and the VAS for back/leg pain. We used QOL data reporting in the general population of 20-29 and 30-39 years of age to compare against our patient cohort. Among the patients, 993 had AIS, 80 congenital scoliosis, 102 syndromic or secondary scoliosis, 105 Scheuermann kyphosis and 40 low-grade and 34 high-grade spondylolisthesis. SRS-22r total and domain scores improved from preoperative to follow-up in all diagnosis categories. At >10 years after surgery, patients with congenital scoliosis and Scheuermann kyphosis had better SRS-22r total/domain and EQ-5D (index/VAS) scores along with lower VAS back/leg pain scores compared to the other groups. Patients with congenital scoliosis and Scheuermann kyphosis had comparable SRS-22r total/domain, EQ-5D (index/VAS) and VAS back/leg pain scores to the general population in the 20-29 year category and better scores than the 30-39 year group. Patients with AIS, syndromic/secondary scoliosis and low/high-grade spondylolisthesis had reduced SRS-22r total/domain and EQ-5D (index/VAS) scores and higher VAS back/leg pain scores compared to the 20-29 year group but comparable scores to the 30-39 year group. Patients with spinal deformity reported improved QOL and high satisfaction after surgery which was maintained at >10 years of follow-up. Patients with congenital scoliosis and Scheuermann kyphosis had better QOL outcomes (comparable to the general population of similar age) as opposed to other types of scoliosis or lumbosacral spondylolisthesis.