SCOLIOSIS SURGERY IN PATIENTS WITH MYELODYSPLASIA: AN OUTCOME STUDY

Abstract

Introduction This is an outcome study of the patients with spina bifida treated for scoliosis by anterior and posterior spinal surgery by a single surgeon at one institution.

Method The clinical notes and radiographs were reviewed of all spina bifida patients with scoliosis undergoing surgery between January 1991 and January 2001. In addition all patients were sent the Spina Bifida Health Related Quality of Life Questionnaire (HRQOL) and the Spina Bifida Spine Questionnaire (SBSQ).

Results There were 19 consecutive patients with an average age at surgery of 13 years 5 months (range). The average neurologic level was T10 (range). 14 patients had staged procedures. At latest follow-up which averaged 60 months (range), there was an overall improvement in scoliosis of 61% from a mean of 83 degrees preoperatively to a mean of 34 degrees postoperatively. There was a corresponding 70% improvement in pelvic obliquity from 27 degrees preoperatively to 8 degrees postoperatively. At latest follow-up which averaged 60 months (range). The major complications included 4 deep infections and 2 pseudarthroses. The deep infections occurred in older patients with more severe curves and were always staged procedures. The patients scored an average of 68.8 on the SBSQ (what does this mean?). The average score on the HRQOL questionnaire for patients 5–12 year old was 178 and 163 for 13–20 year olds.

Discussion There are good radiological results with combined anterior/posterior surgery in this group of spina bifida patients. The outcome scores show that this group of patients enjoy a good quality of life when compared to control groups of similar children with the same condition. An early single stage anterior and posterior spinal fusion is recommended for these patients before the scoliotic curve becomes too large and stiff.