The effect of surgical treatment of idiopathic scoliosis on the quality of life in sick children

Introduction. Idiopathic scoliosis (IS) is a common form of spinal curvature that occurs in children and adolescents. The analysis of the quality of life in such patients is an urgent topic. The PedsQL 4.0 questionnaire is widely used to determine changes in quality of life (QOL).

The aim of the study was to determine changes in the quality of life in children with idiopathic scoliosis, depending on the used tactics of surgical treatment.

Materials and methods. There were examined 88 patients aged 13–18 years, the average age was 15.1 ± 0.61 years, including 20 boys and 68 girls who underwent surgery from 2017 to 2024 for idiopathic scoliosis types I–IV according to L. Lenke score. The patients were divided into 3 groups. The 1^st (control) group consisted of 29 children who underwent a single-stage dorsal correction of scoliosis, supplemented by G1 osteotomy according to F. Schwab. Group 2 consisted of 29 patients who underwent two-stage surgical treatment: at the first stage, preliminary mobilization of the anterior support column of the spine was performed, followed by pelvic traction; at the second stage, dorsal correction of spinal deformity was performed. Group 3 consisted of 30 patients who underwent surgery using a single-stage dorsal correction supplemented by an apical multilevel G2 osteotomy according to F. Schwab. The minimum follow-up period after surgery was 12 months.

Results. The patients of group 1 initially showed high QOL scores on all scales of the questionnaire, while the children of group 2 had low QOL scores in the field of physical and role functioning. The parameters of social and emotional functioning in patients of groups 2 and 3 were similar. Changes in QOL in patients 12 months after surgical treatment turned out to be almost the same. At the same time, a significant improvement in QOL was revealed in patients of groups 2 and 3 compared with children of the control group. An analysis of patients based on baseline values of thoracic kyphosis revealed an improvement in QOL in patients of group 2 with hypokyphosis, which is associated with improved physical health and overall psychosocial functioning (p < 0.05). Patients in group 2 with normokyphosis showed marked improvement in the physical and psychosocial spheres, in contrast to children in group 3. In hyperkyphosis children, the improvement in QOL was more significant in patients of group 3 compared with patients of group 2, especially in the field of general psychosocial functioning (p < 0.02).

Conclusion. The choice of surgical intervention tactics based on the severity of thoracic kyphosis has significantly improved the quality of life in patients after surgical treatment of idiopathic scoliosis. There was a significant increase in scores on the scales of emotional, social, and role functioning. The established patterns can be applied by orthopedists to optimize the choice of tactics for surgical treatment of idiopathic scoliosis in children.

Contribution:
Samokhin K.A., Chelpachenko O.B. — concept and design of the study;
Samokhin K.A., Pimbursky I.P., Butenko A.S., Lyashenko S.N., Kotlubaev R.S. — collection and processing of the material;
Sumenko V.V. — statistical processing of the material;
Samokhin K.A., Chelpachenko O.B. — writing the text;
Zherdev K.V., Yatsyk S.P. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: February 14, 2025
Accepted: March 18, 2025
Published: April 29, 2025

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