Purpose: To assess quality of life in quadriplegic cerebral palsy (CP) after scoliosis surgery.

Methods: This is a study of 43 consecutive patients undergoing instrumented scoliosis correction for quadriplegic CP (2003–2008). The parents completed (telephone) the original DuPont questionnaire (Tsirikos et al 2004, JPO) and 4 additional questions. Each of the 17 items scores from 1 (best) to 5 (worst) with 3 being no change. Retrospective case note and radiograph review was performed.

Two patients had died by the time of follow-up (1 perioperative, 1 unrelated) leaving 41 patients (23 female, 18 male) for analysis. Mean age was 14.0 at surgery, mean follow-up of 2.6 years (0.25–5.3). GMFCS types 2–4 (8), 5 (31). Mean preoperative Cobb angle 78° and pelvic obliquity 18°. There were 34 posterior and 7 anterior and posterior instrumentations.

Results: Mean DuPont score for the original 13 questions was 2.00 compared with 1.75 in the DuPont study. The scores for individual questions ranged from 1.35 to 2.76. The mean score of the 4 additional questions was 2.43, related to transfer ability, reflux and communication. 95% of parents would recommend the surgery again. 75.6% reported an improvement in their child’s ability to sit. Cobb angle correction was 53%, pelvic obliquity correction was 47%. The mean DuPont score is not significantly correlated with Cobb angle or pelvic obliquity correction.

Conclusions: This is the first UK study evaluating the parental view of outcome for scoliosis surgery in quadriplegic CP. Outcome does not seem to be related to radiographic correction. 39 of 41 parents would recommend the surgery.

Ethics approval: none – Clinical Effectiveness Department & PALS

Interest Statement: None

Background: Patients assessed at the clinic are classified and managed according to the guidelines from The Royal College of General Practitioners. The purpose of this study was to evaluate the differences in initial assessment findings between patients with ‘simple’ LBP and those with probable ‘Nerve Root Pain’ (NRP).

Methods: All 1949 new patients attending over two years were assessed using a range of valid and reliable questionnaires to establish generic health status (Short-Form 36; SF36), self reported disability (Oswestry Disability Index; ODI) and psychological status (Hospital Anxiety and Depression Scale; HADS). The spinal examination was carried out by a Senior Physiotherapist and patients were triaged into the various categories of back pain. Differences between groups were assessed for the questionnaire scores and physical examination findings (SLR and lumbar flexion) using Chi-Square Analysis and unrelated T-Tests.

Results: 908 patients were classified as having ‘Simple’ LBP and 302 were classified as having probable ‘Nerve Root Pain’. A significant difference was detected between the two groups for the mean ODI scores (mean difference: −8.73; 95% CI –11.3 to –6.2; P< 0.001). (mean ODI of 36.73 % (SD 18.88%) for ‘Simple LBP’ and 45.46% (SD 22%) for NRP group. Significant differences were also detected for the SF36-Physical Component scores, lumbar flexion and SLR.

Conclusion: The ODI was found to be the strongest discriminator between the two groups. These findings support the inclusion of this condition specific outcome measure in the triage of back pain patients, as it appears to be sensitive to those patients with ‘NRP’.