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.