Quality of Life and Back Pain: Outcome 16.7 Years After Harrington Instrumentation

Introduction: A study on the quality of life of 82 patients with idiopathic scoliosis treated with Harrington instrumentation. To analyze long term health-related quality of life and low back pain an average of 16.7 years after surgery.

Methods: Quality of life was measured with the SF-36 health profile. Low back pain was assessed using the Roland-Morris questionnaire. Demographic data (age, sex, follow-up), radiographic analysis (Kings classification, Cobb angle, extension and site of fusion) and rib cage deformity were correlated with these data.

Results: Compared to the age-matched healthy population, there was no significant difference in the physical SF-36 scale (P=0.98). Surgically treated patients showed significantly lower scores than at baseline in the psychological SF-36 scale (P= 0.005): Vitality (P<0.001), general mental health (P=0.003) and role activities because of emotional problems (P<0.001) were significantly different from those of the age-matched population. Sixty-five (79.3%) of the eighty-two patients reported no or occasional back pain in the Roland Index. Five patients (6.1%) complained of chronic back pain. Neither patient age at the time of surgery (p=0.74) nor time of follow-up (P=0.44), type of scoliosis (P=0.56) or extent of fusion (P=0.12) were associated with health-related quality of life or pain. The size of the preoperative (P=0.06) and postoperative (P=0.12) curve and preoperative (P=0.28) and postoperative (P=0.7) rib cage deformity did not correlate with the data of the SF-36 and the Roland Index.

Conclusions: Compared to the age-matched population, the long-term effect of surgery in operated patients does not affect the physical quality of life. The psychological health status is, however, significantly impaired. Neither the type of curve, nor the size of scoliosis or the rib cage deformity influence the data.