Functional and Radiographic Outcomes Following Growth-Sparing Management of Early-Onset Scoliosis.
Background: In this study, we sought to evaluate radiographic, functional, and quality-of-life outcomes of patients who have completed growth-sparing management of early-onset scoliosis.Methods: This prospective study involved patients with early-onset scoliosis who underwent growth-sparing treatmen...
| Publicado en: | Journal of Bone & Joint Surgery, American Volume Vol. 99; no. 12; pp. 1036 - 1043 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
6/14/2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124266147&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124266147 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00219355 1H2 jtl: Journal of Bone & Joint Surgery, American Volume issn: 00219355 maglogo: N pubinfo: dt: 6/14/2017 vid: 99 iid: 12 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 124266147 124266147 NLM28632593 124266147 10.2106/JBJS.16.00796 NLM28632593 124266147 ppf: 1036 ppct: 7 formats: tig: atl: Functional and Radiographic Outcomes Following Growth-Sparing Management of Early-Onset Scoliosis. aug: au: Johnston, Charles E. Dong-Phuong Tran McClung, Anna Tran, Dong-Phuong affil: Texas Scottish Rite Hospital, Dallas, Texas. sug: subj: Scoliosis Surgery Spinal Fusion Methods Oxygen Consumption Physiology Infant Child, Preschool Scoliosis Physiopathology Lung Volume Measurements Methods Scoliosis Prospective Studies Vital Capacity Physiology Child Osteogenesis, Distraction Methods External Fixators Forced Expiratory Volume Physiology Osteogenesis, Distraction Equipment and Supplies Questionnaires Human Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years ab: Background: In this study, we sought to evaluate radiographic, functional, and quality-of-life outcomes of patients who have completed growth-sparing management of early-onset scoliosis.Methods: This prospective study involved patients with early-onset scoliosis who underwent growth-sparing treatment and either "final" fusion or observation for ≥2 years since the last lengthening procedure. Demographics, radiographic parameters, pulmonary function test (PFT) values, and scores of patient-reported assessments (Early-Onset Scoliosis Questionnaire [EOSQ] and Scoliosis Research Society [SRS]-30) were obtained. At the most recent follow-up, patients performed 2 additional functional outcome tests: step-activity monitoring and a treadmill exercise-tolerance test.Results: Twelve patients were evaluated as "graduates" of growth-sparing management of early-onset scoliosis (mean of 37 months since the most recent surgery). The major scoliosis curve measurement averaged 88° before treatment and 47° at the most recent follow-up. T1-S1 height increased from a mean of 22.3 cm to 34.7 cm and T1-T12 height, from 13.3 to 22.3 cm. At the most recent follow-up, the mean forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) as a percentage of the predicted volume were 52.1% and 55.3%, respectively, and were essentially unchanged from the earliest PFT that patients could perform (FEV1 = 53.8% of predicted and FVC = 53.5% of predicted). There was no difference between graduates and controls with respect to activity time or total steps in step-activity monitoring, and in the exercise-tolerance test, graduates walked at the same speed but at a higher heart rate and at a significantly higher (p <0.001) VO2 cost (rate of oxygen consumed per distance traveled). The EOSQ mean score was 102.2 of a possible 120 points, and the SRS mean score was 4.1 of a possible 5 points.Conclusions: A realistic long-term goal for the management of early-onset scoliosis appears to be spine elongation and maintenance of pulmonary function at a level that is no less than the percentage of normal at initial presentation. Functional testing and patient-reported outcomes at a mean of 3 years from the last surgery suggest that activity levels were generally equal to those of controls but required greater physiologic demand. General health and physical function outcomes revealed continued impairment in these domains.Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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