Patient outcomes after Harrington instrumentation for idiopathic scoliosis- A 15-to 28-year evaluation

Study Design. A retrospective study was performed, using the Short Form-36 Health Survey and the Roland and Morris Disability Questionnaire, to invest igate patient outcomes after fusion for adolescent idiopathic scoliosis usi ng Harrington rod instrumentation. Objective. To evaluate health-related quality of life and low back pain in a long-term follow-up study of surgery for adolescent idiopathic scoliosis. Summary of Background Data. The commonly accepted surgical treatment for id iopathic evolutive scoliosis is vertebral fusion. It has been suggested tha t this procedure may cause low back pain and a poor quality of life over th e long term. Outcome measures after surgery for adolescent idiopathic scoli osis have focused mainly on objective parameters such as radiographic measu res. However, this information has proved to be correlated only weakly with outcomes that are more relevant to patients, such as functional status and symptoms. Until recently, only a few long-term outcome studies have used s tandardized and validated patient-oriented tools to evaluate surgically tre ated patients with scoliosis. Methods. In this study, 70 patients treated with a standard Harrington tech nique were recontacted and evaluated by means of self-administered question naires (Short Form-36 Health Survey and Roland and Morris Disability, clini cal examination, and radiographic analysis. Preoperative and follow-up radi ographic findings were registered. Relations between radiographic and patie nt-oriented data were evaluated. Results, A comparison between the current sample and the Italian age-matche d normative data for the Short Form-36 Health Survey showed them to have a similar pattern. Findings showed the patient-oriented outcome to be correla ted inversely with the extension of vertebral fusion and the preoperative C obb angle. Conclusion. Long-term follow-up evaluation of Harrington rod fusion for ado lescent idiopathic scoliosis showed no important impairment of health-relat ed quality of life, as measured by patient-oriented evaluation.