IS QUALITY OF LIFE WORSE IN PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS WHO UNDERGO LONGER FUSIONS? 2 YEARS OF FOLLOW-UP

Chaves Filho, Amauri; Quaggiotto, Jeinnifer Zanardo; Zanon, Igor de Barcellos; Batista Júnior, José lucas; Cardoso, Igor Machado; Jacob Júnior, Charbel

doi:10.1590/S1808-185120222102261930

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Original Article, Deformities • Coluna/Columna. 21 (2) • 2022 • https://doi.org/10.1590/S1808-185120222102261930 copy

IS QUALITY OF LIFE WORSE IN PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS WHO UNDERGO LONGER FUSIONS? 2 YEARS OF FOLLOW-UP

A QUALIDADE DE VIDA É PIOR EM PACIENTES COM ESCOLIOSE IDIOPÁTICA DO ADOLESCENTE SUBMETIDOS A FUSÕES MAIS LONGAS? ACOMPANHAMENTO DE DOIS ANOS

¿ES PEOR LA CALIDAD DE VIDA DE PACIENTES CON ESCOLIOSIS IDIOPÁTICA DEL ADOLESCENTE SOMETIDOS A FUSIONES MÁS LARGAS? 2 AÑOS DE SEGUIMIENTO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To compare quality of life in patients with longer fusions with that of those who have short fusions 2 years of after surgery.

Methods:

This is a retrospective comparative cohort study (Level of Evidence III) involving patients with adolescent idiopathic scoliosis who underwent posterior spinal fusion with pedicle screws with a 2-year follow-up. The primary outcome was quality of life assessed using the SRS-30 questionnaire. Participants were divided according to Lenke and stratified into those with major (Lenke 3 and Lenke 6) and minor (Lenke 1 and Lenke 5) fusions.

Results:

Forty-one patients, 34 of whom were women, were evaluated: Lenke 1 (17 patients), Lenke 3 (15 patients), Lenke 5 (3 patients), and Lenke 6 (6 patients). The mean age was 13.8 years, the mean preoperative and postoperative Cobb angles were 56.48 degrees and 10.49 degrees, respectively, and the mean surgical Cobb reduction was 45.54 degrees. All patients in the sample showed an overall improvement in quality of life after surgery (p<0.0001). There was no difference between groups A (long fusions) and B (short fusions) in relation to the domains in general (p>0.05). Although pain was improved in the overall sample, this was not the case for the group with structured double curves and longer fusions (p = 0.03).

Conclusion:

There was no difference in quality of life between patients with long and short fusions with a 2-year follow-up. Level of Evidence III; Retrospective cohort.

Keywords:
Quality of Life; Scoliosis; Arthrodesis; Spinal Fusion

Variable	Category	N	%
Sex	Female	34	82.9%
Sex	Male	7	17.1%
Age	12	14	34.1%
	13 to 14	12	29.3%
	15 to 17	15	36.6%
Mobility	Greater (Lenke 1 and 5)	20	48.8%
Mobility	Lesser (Lenke 3 and 6)	21	51.2%
Lenke	1	17	41.5 %
	3	15	36.6 %
	5	3	7.3 %
	6	6	14.6 %

Domain	Minimum	Median	Maximum	Mean	SD
Overall	1.20	2.77	4.33	2.80	0.73
Function/Activity	-0.20	0.20	0.20	0.13	0.11
Pain	-0.60	0.20	1.20	0.26	0.41
Self-image	0.17	0.83	1.67	0.89	0.37
Mental Health	-0.80	0.00	0.60	-0.08	0.32
Satisfaction with Management	1.00	1.50	2.50	1.61	0.49

Domain	Minimum	Median	Maximum	Mean	SD
Overall	18.17	19.67	20.87	19.66	0.61
Function/Activity	4.40	4.40	4.60	4.45	0.09
Pain	3.80	4.60	5.00	4.60	0.32
Self-image	2.17	2.83	3.33	2.76	0.31
Mental Health	4.40	4.80	5.00	4.81	0.21
Satisfaction with Management	2.50	3.00	3.50	3.04	0.36

Domain	Minimum	Median	Maximum	Mean	SD	Wilcoxon (P-Value)
Overall	1.20	2.77	4.33	2.80	0.73	< 0.0001
Function/Activity	-0.20	0.20	0.20	0.13	0.11	< 0.0001
Pain	-0.60	0.20	1.20	0.26	0.41	0.0003
Self-image	0.17	0.83	1.67	0.89	0.37	< 0.0001
Mental Health	-0.80	0.00	0.60	-0.08	0.32	0.9642
Satisfaction with Management	1.00	1.50	2.50	1.61	0.49	< 0.0001

Domain	Lenke	Minimum	Median	Maximum	Mean	SD	Kruskal-Wallis (P-Value)
Overall	1	1.93	2.70	3.87	2.77	0.60	0.6127
	5	2.03	2.23	3.00	2.42	0.51
	3	1.20	3.10	4.30	2.79	0.91
	6 1	2.53	2.87	4.33	3.12	0.70
Function / Activity	1	-0.20	0.20	0.20	0.13	0.12	0.9994
	5	0.00	0.20	0.20	0.13	0.12
	3	0.00	0.20	0.20	0.13	0.10
	6	0.00	0.20	0.20	0.13	0.10
Pain	1	-0.60	0.20	1.20	0.16	0.46	0.1471
	5	0.00	0.00	0.20	0.07	0.12
	3	-0.60	0.40	1.20	0.33	0.40
	6	0.20	0.40	0.80	0.43	0.23
Self-image	1	0.33	0.83	1.67	1.01	0.38	0.4986
	5	0.33	0.83	1.00	0.72	0.35
	3	0.17	0.67	1.33	0.80	0.36
	6	0.33	0.83	1.17	0.83	0.32
Mental Health	1	-0.80	0.00	0.60	-0.04	0.36	0.6468
	5	-0.20	0.00	0.20	0.00	0.20
	3	-0.80	-0.20	0.20	-0.17	0.29
	6 1	-0.60	0.00	0.40	-0.03	0.32
Satisfaction with Management	1	1.00	1.50	2.00	1.50	0.43	0.6457
	5	1.00	1.50	2.00	1.50	0.50
	3	1.00	1.50	2.50	1.70	0.56
	6	1.00	1.75	2.50	1.75	0.52

Domain	Lenke	Minimum	Median	Maximum	Mean	SD	Exact W-MW (P-Value)
Overall	1 and 5	1.93	2.67	3.87	2.72	0.59	0.3617
Overall	3 and 6	1.20	2.97	4.33	2.89	0.85	0.3617
Function/ Activity	1 and 5	-0.20	0.20	0.20	0.13	0.12	1
Function/ Activity	3 and 6	0.00	0.20	0.20	0.13	0.10	1
Pain	1 and 5	-0.60	0.10	1.20	0.15	0.43	0.0359
Pain	3 and 6	-0.60	0.40	1.20	0.36	0.36	0.0359
Self-image	1 and 5	0.33	0.83	1.67	0.97	0.38	0.2543
Self-image	3 and 6	0.17	0.83	1.33	0.81	0.34	0.2543
Mental Health	1 and 5	-0.80	0.00	0.60	-0.03	0.34	0.3766
Mental Health	3 and 6	-0.80	0.00	0.40	-0.13	0.30	0.3766
Satisfaction with Management	1 and 5	1.00	1.50	2.00	1.50	0.43	0.2098
Satisfaction with Management	3 and 6	1.00	1.50	2.50	1.71	0.54	0.2098

Factor	Lenke	Minimum	Median	Maximum	Mean	SD	Exact W-MW (P-Value)
Cobb (Post – Pre)	1 and 5	-64.00	-41.80	-32.20	-43.27	7.98	0.0839
Cobb (Post – Pre)	3 and 6	-65.10	-46.30	-32.40	-47.81	9.57	0.0839

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E-mail: coluna.columna@uol.com.br

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[1] Correspondence: Amauri Chaves Filho. Hospital da Santa Casa de Misericórdia de Vitória – Rua Dr. João dos Santos Neves, 143 – Vila Rubim, Vitória, ES, Brasil. amauricf20@gmail.com