Quality of life in children and adolescents undergoing spinal deformity surgery

BACKGROUND: Quality of life measurements evaluate surgical results from patients' reported outcomes. OBJECTIVE: To assess the impact of spinal deformity treatment using the Scoliosis Research Society-22 questionnaire. METHODS: SRS-22 data was collected in 545 consecutive patients (425 females-120 males) pre-operatively, 6-, 12-and 24months post-operatively. Variables included type and age of surgery (mean: 15.14 +/- 2.07 years), gender, diagnosis and year of surgery. Age at surgery was divided in: 10-12, 13-15, and 15-19 years. RESULTS: Mean pre-operative SRS-22 scores for the whole group were: function 3.77 +/- 0.75; pain 3.7 +/- 0.97; self-image 3.14 +/- 0.66; mental health 3.86 +/- 0.77; total 3.62 +/- 0.66. Mean 2-year post-operative scores were: function 4.39 +/- 0.42; pain 4.59 +/- 0.56; self-image 4.39 +/- 0.51; mental health 4.43 +/- 0.56; satisfaction 4.81 +/- 0.40; total 4.52 +/- 0.37 (p < 0.0001). Males performed better at 2-years post-surgery (4.62 +/- 0.25) compared to females (4.49 +/- 0.39), (p = 0.004). Patients with spondylolisthesis performed worse pre-operatively (2.93 +/- 0.26) compared to other diagnoses (p < 0.0001). This did not impact 2-year post-operative outcomes. There were no significant changes regarding age or year of surgery, type of operation or between the 3 age groups. CONCLUSIONS: All individual domains and total SRS-22 scores improved significantly with incremental change during postoperative follow-up. Patient satisfaction was very high for all individual diagnosis. 2-year post-operative outcomes compared favorably to reported SRS-22 scores in healthy adolescents.