Abstract
This is an outcome study of patients with spina bifida treated for scoliosis by anterior and posterior spinal surgery at the Starship Children’s Hospital.
The clinical notes and radiographs were reviewed of all spina bifida patients with scoliosis undergoing surgery between January 1991 and January 2001. In addition all patients were sent the Spina Bifida Health Related Quality of Life Questionnaire (HRQOL) and the Spina Bifida Spine Questionnaire (SBSQ). There were 19 consecutive patients with an average age at surgery of 13 years 5 months. Four patients had both anterior and posterior instrumentation. 14 patients had staged procedures.
There was an overall improvement in scoliosis of 61% and pelvic obliquity of 70% at latest follow-up that averaged 60 months. The major complications included 4 deep infections and 2 pseudarthroses. The patients scored an average of 68.8 on the SBSQ. The average score for 5–12 years old was178 and for 13–30 years old, 163, on the HRQOL questionnaire. There are good radiological results with combined anterior/posterior surgery in this group of spina bifida patients. Quality of Life does not seem to be greatly compromised in the operated spina bifida patient.
We recommend early single stage anterior and posterior fusion for these patients before the curve becomes too large and stiff.
Correspondence should be addressed to the editorial secretary: Associate Professor Jean-Claude Theis, Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
