Health-related quality of life in syndromic scoliosis treated by segmental pedicle screw instrumentation: a case-control study

Abstract

<p><strong>Background and purpose: </strong>Deformity correction with pedicle screw instrumentation in adolescent idiopathic scoliosis has been shown to improve the health-related quality of life (HRQoL), while evidence on syndromic scoliosis is limited. Syndromic patients tend to have comorbidities resulting in a higher risk of perioperative complications. We aimed to assess the change in HRQoL in patients with syndromic scoliosis compared with adolescent idiopathic scoliosis after spinal fusion with pedicle screw instrumentation.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study in children undergoing segmental pedicle screw instrumentation for syndromic scoliosis between 2009 and 2023 with a 2-year follow-up. For each syndromic patient, 2 controls with adolescent idiopathic scoliosis were matched for sex and age. The Scoliosis Research Society-24 (SRS-24) questionnaire was used to assess HRQoL preoperatively and at follow-up.</p><p><strong>Results: </strong>35 syndromic (mean age 14.1 years) and 70 adolescent idiopathic patients (mean age 15.1 years) were included. The SRS-24 total score remained stable from preoperative to 2-year follow-up in both groups (median difference for change 0.05, 95% confidence interval [CI] -0.40 to 0.30). The pain domain improved 0.9 points (standard deviation [SD] 0.9) in syndromic and 1.0 points (SD 0.7) in adolescent idiopathic scoliosis patients. Non-ambulatory patients had greater improvement in pain than ambulatory syndromic patients (mean difference between groups 0.66, CI 0.15-1.24). 8 syndromic patients had complications compared with 3 adolescent idiopathic scoliosis patients (risk ratio 5.3, CI 1.5-19). One syndromic patient died during follow-up.</p><p><strong>Conclusion: </strong>The health-related quality of life in patients with syndromic scoliosis was comparable to patients with adolescent idiopathic scoliosis after posterior spinal fusion with segmental pedicle screw instrumentation.</p>