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Meaningful improvement in HRQoL seen after spinal fusion for patients with non-ambulatory cerebral palsy
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PHILADELPHIA — At the Scoliosis Research Society Annual Meeting, a presenter said that at 2-year follow-up after posterior spinal fusion for non-ambulatory cerebral palsy, one-third of patients demonstrated meaningful improvement in health-related quality of life.
“Radiographic parameters were not associated with clinical improvement at all,” Daniel J. Miller, MD, said during his presentation. “Patients who demonstrated a meaningful improvement tended to start with a lower preoperative [caregiver priorities and child health index of life with disabilities] CPCHILD score. This may suggest these patients may have more room for improvement from spinal fusion surgery.”
Miller and colleagues retrospectively reviewed a multicenter database and identified 157 patients with non-ambulatory cerebral palsy (CP) who underwent posterior spinal fusion. The minimum follow-up was 2 years. Preoperatively and 2-years postoperatively, investigators assessed radiographs and health-related quality of life (HRQoL)with the CPCHILD questionnaire. Patients with substantial improvement were compared to those without improvement.
Results showed about one-third of patients at the 2-year follow-up demonstrated a meaningful improvement in HRQoL, which reflected a 10-point increase or more in the CPCHILD score from the preoperative score. Patients who had a meaningful improvement compared with those who did not were not different with regard to the gross motor function classification system, function or status, according to Miller. The two groups were not different with regard to the radiographic measures of deformity correction.
“We found the patients who demonstrated meaningful improvement had lower preoperative CPCHILD score,” he said. “A subgroup analysis was performed and found that patients who started with a preoperative CPCHILD score of less than 50 were 2.5-times more likely to have a meaningful improvement at 2 years postoperative when compared with those who started above 50.” – by Monica Jaramillo
Reference:
Miller DJ, et al. Paper #91. Presented at: Scoliosis Research Society Annual Meeting; September 6-9, 2017; Philadelphia.
Disclosure: Miller reports no relevant financial disclosures.