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© 2014 The British Editorial Society of Bone & Joint Surgery. The purpose of this study was to evaluate the long-term outcome of adults with spina bifida cystica (SBC) who had been treated either operatively or non-operatively for scoliosis during childhood. We reviewed 45 patients with a SBC scoliosis (Cobb angle ≥ 50°) who had been treated at one of two children's hospitals between 1991 and 2007. Of these, 34 (75.6%) had been treated operatively and 11 (24.4%) non-operatively. After a mean follow-up of 14.1 years (standard deviation (SD) 4.3) clinical, radiological and health-related quality of life (HRQOL) outcomes were evaluated using the Spina Bifida Spine Questionnaire (SBSQ) and the 36- Item Short Form Health Survey (SF-36). Although patients in the two groups were demographically similar, those who had undergone surgery h ad a larger mean Cobb angle (88.0° (SD 20.5; 50.0 to 122.0); versus 65.7° (SD 22.0; 51.0 to 115.0); p < 0.01) and a larger mean clavicle-rib intersection difference (12.3 mm; (SD 8.5; 1 to 37); versus 4.1 mm, (SD 5.9; 0 to 16); p = 0.01) than those treated nonoperatively. Both groups were statistically similar at follow-up with respect to walking capacity, neurological motor level, sitting balance and health-related quality of life (HRQOL) outcomes. Spinal fusion in SBC scoliosis corrects coronal deformity and stops progression of the curve but has no clear effect on HRQOL.

Original publication

DOI

10.1302/0301-620X.96B9.33857$2.00

Type

Journal article

Journal

Bone and Joint Journal

Publication Date

01/09/2014

Volume

69B

Pages

1244 - 1251