Outcome Assessment in Neuromuscular Spinal Deformity

Abstract

Patient-based outcome measures are important tools quantifying the disease-specific and/or global quality of life (QOL) effects of spinal deformity treatment. In patients with neuromuscular disorders such as cerebral palsy, muscular dystrophy, and myelomeningocele, treatment effects must be differentiated from underlying disease functional impairments. In general, the goals of spinal surgery in these patients are to improve QOL by enhancing sitting balance and posture, improving lung and gastrointestinal function, and reducing pain and deformity. In selected patients, improving ambulation and hand function may also be realistic surgical goals. QOL measures specific to both the neuromuscular diagnosis and spinal deformity provide higher quality information on treatment outcomes for a particular patient than standard radiographic measures. This article reviews patient-based outcome measures in spinal deformity patients with neuromuscular disorders, including their development and use in comparative outcome studies in the recent literature.

Trends in Treatment of Scheuermann Kyphosis: A Study of 1,070 Cases From 2003 to 2012

“…Advances in materials and implants used in spine surgery and technology available then led to a shift toward posterior-only approach surgeries for SK to avoid the high morbidity rates with combined-approach procedures. These posterior-only surgeries with associated pedicle screws and Smith-Peterson osteotomies have been reported as achieving and maintaining better correction and had fewer complications than combined-approach procedures in the treatment of SK [17][18][19]. These improvements demonstrate that in select cases, the need for combined-approach surgeries for SK can be obviated and posterior-only surgeries can be performed instead, with better reported outcomes.…”

Health Economics in Pediatric Orthopaedic Surgery

“…Disease-specific outcome measures focus on interventions related to a particular disease, area of the body, or injury pattern. 30 These include the Muscular Dystrophy Spine Questionnaire for Duchene's Muscular Dystrophy and the Caregiver's Priorities and Child Health Index of Life with Disabilities (CPCHILD) Questionnaire for cerebral palsy, which are valid and reliable for their respective diagnoses. [30][31][32] Diseasespecific outcome measures are advantageous in detecting health changes in specific conditions.…”

Analysis of the Ways for Non-Instrumental Evaluation of Functional Condition of the Patients With Neuromuscular Scoliosis

“…В некоторых исследованиях была предпринята попытка разработать собственную форму оценки нервно-мышечного сколиоза в соответствии с основной патологией, такой как церебральный паралич и миодистрофия Дюшенна; однако неоднородность пациентов препятствует разработке единой анкеты [13,17,18]. Вследствие гетерогенности этих пациентов важно группировать их в соответствии с их конкретным заболеванием [6,19].…”

“…Измерение результатов на основе данных пациентов является важным инструментом количественной оценки воздействия лечения деформации позвоночника на определенные заболевания и/или глобальное качество жизни [13]. У пациентов с нервно-мышечными нарушениями, такими как церебральный паралич, мышечная дистрофия и миеломенингоцеле, лечебные эффекты должны быть дифференцированы от основных функциональных нарушений.…”