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Abstract from the 2006 SRS Annual Meeting
a - Synthes Spine
b - Synthes Spine
c - Synthes Spine
Purpose: In contrast to children with adolescent idiopathic
scoliosis, children with early onset scoliosis often have significant comorbidities
and can rapidly develop thoracic insufficiency and pulmonary compromise which
has a profound effect on their lives. The traditional surgical or non-surgical
techniques to treat Thoracic Insufficiency Syndrome (TIS) are not able to stabilize
or improve chest wall size or pulmonary function while allowing spine growth.
To this end, Vertical Expandable Prosthetic Titanium Rib (VEPTR) was specifically
designed to treat TIS by allowing growth of the thoracic cavity and control/correction
of spine deformity. The purpose of this study is to compare quality of life
(QOL) of children with TIS, prior to implantation of VEPTR, with previously
published QOL of healthy children as well as to that of children with other
diseases.
Method: As part of the original multicenter evaluation of
the VEPTR, Child Health Questionnaire (CHQ) was collected preoperatively on
forty five patients who were subsequently treated with expansion thoracoplasty
using the VEPTR. The average age was 8.2±2.6 and parent form of the CHQ was
filled out by the primary caretaker. Patients were divided in to three broad
diagnostic categories; Rib Fusion (RF, N=15), Hypoplastic Thorax Syndromes (HT,
N=17) and Progressive Spinal Deformity (PS, N=13).
Results: There were significant differences between the study
patients and healthy children in Physical Functioning, Role/Social Limitations-Physical,
General Health Perceptions, Parental Impact-Emotional, Parental Impact-Time,
Family Activities, Physical Summary, and Psychosocial Summary (Table).
Discussion: Patients with thoracic insufficiency syndrome
have significant and profound perturbations in QOL when compared with other
children. These scores are among the lowest observed in pediatric populations.
Current efforts are underway to better understand the clinical features that
have the most profound effects on the life of these children. Finally, these
data will serve as an important baseline on ongoing studies of these patients
after expansion thoracoplasty.
| |
RF Mean (SD)
|
HT Mean (SD)
|
PS Mean (SD)
|
Norms Mean (SD)
|
| Physical Functioning |
81.3
(22.7)*
|
66.0
(30.1)**
|
53.5
(37.0)**
|
|
| Role/Social Limitations - Physicial |
97.8
(8.6)
|
67.6
(37.0)*
|
74.4
(40.6)
|
|
| General Health Perceptions |
627
(20.1)
|
45.8
(19.9)***
|
50.1
(18.9)**
|
|
| Parental Impact - Emotional |
52.3
(29.9)**
|
57.8
(27.0)**
|
46.8
(29.8)**
|
|
| Parental Impact - Time |
56.3
(23.6)***
|
54.7
(24.7)***
|
60.4
(20.8)**
|
|
| Family Activities |
78.3
(19.7)*
|
74.7
(24.7)*
|
77.4
(28.5)
|
|
| Physical Summary |
47.4
(8.3)*
|
32.2
(20.1)**
|
30.2
(14.7)**
|
|
| Psychosocial Summary |
45.4
(5.9)**
|
48.9
(6.1)
|
47.1
(8.3)
|
|
*p<.05.
**p<.01.
***p<.001
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