3rd International Congress on Early Onset Scoliosis Valutations of quality of life after spine fusio

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3rd International Congress on Early Onset
Scoliosis Valutations of quality of life
after spine fusion in children affected by
neuromuscolar scoliosis

• Luca F. Colombo
• Francesco Motta
• Children H. V.Buzzi Milano Italy
• lucafco_at_icp.mi.it
• f.motta_at_icp.mi.it

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Pourpose

• To investigate possible chancing in the quality
  of life in children affected by neuromuscolar
  scoliosis after spine surgery. This is a
  retrospective 5 years follow up study. All the
  patients were evalueted after 6 mounth with SRS
  22 and a 27 subjective questionaire.
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Methods

• Since 2003 we treated 112 patients affected by
  neuromuscolar scoliosis ( SMA, Duchenne
  Distrophy, Mielomeningocele, Cerebral palsy)
• All the patients underwent posterior spine fusion
  and Unit Rod instrumentation .
• 112 consecutive patients (68 girls, 48 boys) mean
  age 14 y.o. (11 - 19)
• Mean preoperative curve magnitude was 84, range
  62 to 120
• All patients were evalueted after 6 mounth,from
  surgery, with SRS 22 and a 27 subjective
  questionaire
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RX control pre e post surgery Unit Rod
instrumentation in patients with itbt pump
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27 subjective questionaire

• The parameters
• Rigidity , dystonia, clonus, defecation, self
  care, dressing, feeding, moovment around home ,
  fisiotheraphy, head control,moovment of the
  arms,of the legs, trunk control, level of
  activity, position and activity in the weel
  chair, sleeping, respiratory level, self images,
  pain, speches, personal relationship, mood,
  treatment satisfaction
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SRS 22 112 patients

• Function and activity 3,8
• Pain 4,5
• Mental health 3,8
• Satisfaction with management 4,2
• Tot 4,0
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Results

• Spine curvature mean correction was 58
• and Cobb angle 43
• (28 - 58)
• Pelvic obliquity mean correction was 56
• range 20to 43 mean correction 31
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Results the Subjective post-op questionnaire

• 27 questions for patients/families
• 0 worsenend
• 32 unchanged
• 68 improved
• The main improvements where described for
• pain
• Sitting balance
• Physical appearance
• Easy of self care
• Eating
• breathing
• 90 declare to recommend spine fusion
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Conclusion

• Scoliosis in neuromuscolar patients is an
  evolutive desease and the conservative treatment
  is not usefull.
• In time they loose the balance for the setting
  position and they begin to have pain , sores,
  difficulties in eating and breathing
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Conclusion

• We analyzed the results of the questionaire
  indipendent from the X Ray results
• The evidence is that all the patients had real
  improvment of the spinal deformity and of their
  quality of life.
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We can conclude that spine surgery is indicated
in patients affected by neuromuscolar scoliosis
to prevent poor expectation of their life
3rd ICEOS Congress (same patients pre-post
surgery)
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References

• Tsiricos,Athanasios.MD Chang,Wei-Ning MD
  Dabney Kirk MD Miller Freeman MD
• Comparison of Parents and Cargivers satisfaction
  after spinal fusion in children with cerebral
  palsy
• JPO v.24 jenfeb 2004 pp 54-58

• Kevin B Jones,B.A. Paul D. Sponseller, MD
  Michael K. Shindle,BA Melissa L. Mc Carthy,
  Sc.D.
• Longitudinal parental perceptions os spinal
  fusion for neuromuscolar spine deformity in
  patients totally involved cerebral palsy
• JPO 2003 23 (2) 143-149
• Dias RC , Miller F , Dabney K , Lipton G, Temple
  T,
• Surgical correction of spinal deformity using a
  Unit Rod in children with cerebral palsy
• Pediatric Orthop. 1996 16734-740