Studies Open for Enrollment
A Retrospective Cohort Study of Pulmonary Function, Radiographic Measures, and Quality of Life in Children with Scoliosis: An Evaluation of Patient Outcomes After Traditional Spine Surgery
 Purpose
The primary objective of this study is to evaluate the pulmonary function, radiographic congenital scoliosis, infantile scoliosis, or juvenile scoliosis at our institution. measures, and quality of life outcomes of children who underwent traditional spine surgery for the treatment of their progressive
What are Pulmonary Function Tests and why are they important?
Pulmonary Function Tests (PFT) measure how well the lungs are working. There are several different types of pulmonary function tests. Spirometry measures the amount of air the lungs can hold. Lung volume tests measure the amount of air remaining in the lungs after exhaling. There are also lung diffusion tests and pulse oximetry which measure the amount of oxygen passed from the lungs to the blood.
Our patients undergo a set of regular pulmonary function tests (PFTs). This is important because patients with progressive scoliosis sometimes have compromised pulmonary function as a result of their spinal deformity.
What are Radiographic Measures and why are they important?
Scoliosis is measured by the magnitude of the curve in the spine. In order to view and measure the magnitude and location of the curve, physicians order patients to have radiographs, or x-rays taken. The radiographic assessment (viewing and reading of the x-rays) first begins with a lateral view of the entire spine. From this radiographic assessment the physician can determine what type of curvature is present. The second radiographic assessment analyzes bending films. Bending films are taken to assess the rigidity or flexibility of the curve. The more flexible the curve, the greater the chance for correction during treatment.
What are Quality of Life Outcomes Measures?
The term "quality of life" refers to the physical, psychological and social domains of health. These health-related domains are seen as distinct areas that are influenced by a person's experiences, beliefs, expectations, and perceptions. Each of these domains can be measured in two ways: objectively and subjectively. Objective assessments of functioning or health status might come from the physician. Subjective assessments of functioning or health status might come from the patient or, in the case of measuring caregiver burden, the caregivers themselves. Although objective measures are important, subjective assessments are just as- if not more important. This is because expectations regarding health and the ability to cope with limitations and disability greatly affect a person's perception of health and satisfaction with life. Therefore, two people with the same health status, may have very different qualities of life.
This study administers a Child Health Questionnaire (CHQ). The CHQ is a general health measure designed to assess the overall physical and psychosocial well being of children and adolescents between 5 and 18 years of age. This instrument attempts to evaluate many different domains of your child's health. For example:
Physical Functioning Domain
During the past 4 weeks has your child been limited to doing things that take a lot of energy such as playing soccer or running?
Emotional/Behavioral Domain
During the past 4 weeks has your child been limited in the amount of time he/she could spend on schoolwork or activities with friends due to emotional difficulties or problems with his/her behavior?
Parental Impact-Emotional
During the past 4 weeks, how much emotional worry or concern did your child's physical health cause you?
Who are Eligible?
Children that are 3 and a half years or older with a primary diagnosis of progressive congenital scoliosis, infantile scoliosis or juvenile scoliosis are eligible for the study. Also, these patients must have been treated with traditional spinal surgery at our institution at least two years ago. The inclusion criteria were chosen to select those patients with progressive scoliosis whose pulmonary function is affected to various degrees by their spinal deformity.
Study Procedures/Recruitment
In order to identify eligible patients for this study, the research team will conduct an extensive review of patients' charts, attending surgery logs, and various hospital databases. Once these patients have been identified, their last treating physician in the Division of Pediatric Orthopaedics will contact them via mail or telephone to recruit them into this study. Patients who agree to participate will be invited to our hospital for a single followup study visit with a pediatric orthopaedic surgeon and a pediatric pulmonologist.
Hospital Visit
Upon completing their informed consent, patients who have had surgery for the treatment of their progressive scoliosis and their parents will be invited for a single followup study with a pediatric orthopaedic surgeon and a pediatric pulmonologist. At this followup visit, we will evaluate the pulmonary function, radiographic measures, and quality of life outcomes of these study patients. Although pulmonary function tests are routinely collected on patients with various conditions that effect lung function, it has not been the standard of care at our institution for patients with progressive scoliosis. Therefore, in order to evaluate their pulmonary function, it is necessary for all study patients to undergo a set of pulmonary function tests as part of this study. Furthermore, given that some patients may not have recent radiographs of the spine or quality of life assessments (eg. Patients may have had surgery at our institution many years ago with no recent followup evaluations), it is also necessary to obtain recent radiographs of the spine and quality of life data at this followup visit.
Enrolled Participants
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