Does quality of life vary widely for those whose scoliosis began in adolescence?
New Data on Scoliosis and Quality of Life
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Secondary#scoliosis
That was one of the questions researchers from Sweden set out to answer in their recent study, “Health-Related Quality of Life in Adulthood in Untreated and Treated Individuals with Adolescent or Juvenile Idiopathic Scoliosis.” The study appears in the May 16, 2018 edition of The Journal of Bone and Joint Surgery.
Co-author Elias Diarbakerli, M.D., with the Department of Orthopaedics at Karolinska University Hospital in Stockholm, Sweden, told OTW, “Previous studies have shown overall similar quality of life in treated individuals (i.e., braced and surgically treated). We had data on a large sample of individuals with idiopathic scoliosis, including untreated individuals (who were only observed at adolescence). We were interested to see if quality of life did differ at long-term between these three groups.”
“Our findings indicated small differences between the three groups where the surgically treated individuals had slightly lower scores on quality of life outcomes.”
“The results of particular interest are that 1) onset of idiopathic scoliosis (i.e., juvenile or adolescent) does not affect quality of life outcomes, 2) surgically treated individuals with fusion in the lower lumbar spine have significantly decreased quality of life outcomes and 3) surgically treated individuals are significantly more satisfied with their treatment (despite scoring lower on many quality of life outcomes) than their braced peers.”
“Our treatment strategies for idiopathic scoliosis seem to be appropriate where patients function well in life at adulthood, irrespective of type of treatment. Using self-assessed scores is a good complement to objective measures in order to evaluate the way we manage our patients, both in short and long-term.”
“For surgeons, it is important to assess the need of extending fusion to the lower lumbar spine. Previous studies, confirmed by our findings, shows that quality of life in adulthood is negatively affected when fusion is extended in the lower lumbar spine.”
“For all clinicians managing idiopathic scoliosis, it is good to be aware of the overall similarity in quality of life outcomes between treatment groups at long-term.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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